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WELLTOWER INC. (WELL)

CIK: 0000766704. SIC: 6798 Real Estate Investment Trusts. Latest 10-K as of: 2026-02-12.

SIC breadcrumb: Finance, Insurance, And Real Estate > Holding And Other Investment Offices > SIC 6798 Real Estate Investment Trusts

SEC company page: https://www.sec.gov/edgar/browse/?CIK=766704. Latest filing source: 0000766704-26-000010.

Informational only - descriptive public-record data, not investment advice.

Selected Fundamentals

MetricValueUnitFYFiled
Revenue10,838,034,000USD20252026-02-12
Net income961,837,000USD20252026-02-12
Assets67,303,047,000USD20252026-02-12

Financials

Annual standardized facts from SEC companyfacts as of latest extracted filing date 2026-02-12. Source: https://data.sec.gov/api/xbrl/companyfacts/CIK0000766704.json. Derived margins, ratios, and free cash flow are computed from the extracted annual SEC facts.

Flow metrics use full-year FY periods from 10-K/10-K/A filings; balance-sheet metrics use FY-end instants. Free cash flow = operating cash flow - capital expenditures. Missing metrics are omitted rather than fabricated.

Metric2016201720182019202020212022202320242025
Revenue4,281,160,0004,316,641,0004,700,499,0005,121,306,0004,605,967,0004,742,115,0005,860,615,0006,637,995,0007,991,118,00010,838,034,000
Net income1,082,070,000540,613,000829,750,0001,330,410,0001,038,852,000374,479,000160,568,000358,139,000972,857,000961,837,000
Diluted EPS2.811.262.023.052.330.780.300.661.571.39
Operating cash flow1,639,064,0001,434,177,0001,583,944,0001,535,968,0001,364,756,0001,275,325,0001,328,708,0001,601,861,0002,256,421,0002,881,677,000
Dividends paid1,119,232,0001,035,906,0001,131,527,0001,260,578,0001,545,275,0001,877,959,000
Assets28,865,184,00027,944,445,00030,342,072,00033,380,751,00032,483,642,00034,910,325,00037,893,233,00044,012,166,00051,044,308,00067,303,047,000
Liabilities13,185,279,00012,643,799,00014,331,427,00016,398,247,00015,258,580,00015,912,452,00016,499,237,00017,640,439,00018,471,722,00024,100,108,000
Stockholders' equity14,806,393,00014,423,147,00014,632,334,00015,540,444,00015,972,719,00017,636,001,00020,294,814,00025,404,376,00031,956,208,00042,129,498,000
Cash and cash equivalents419,378,000243,777,000381,913,000284,917,0001,545,046,000269,265,000631,681,0001,993,646,0003,506,586,0005,033,678,000

Ratios

ROE and ROA use period-end equity/assets. Liabilities / equity uses total liabilities divided by stockholders' equity. Current ratio uses current assets divided by current liabilities when both are reported.

Metric2016201720182019202020212022202320242025
Net margin25.28%12.52%17.65%25.98%22.55%7.90%2.74%5.40%12.17%8.87%
Return on equity7.31%3.75%5.67%8.56%6.50%2.12%0.79%1.41%3.04%2.28%
Return on assets3.75%1.93%2.73%3.99%3.20%1.07%0.42%0.81%1.91%1.43%
Liabilities / equity0.890.880.981.060.960.900.810.690.580.57

Financial Charts

Quarterly

Quarterly standardized facts from SEC companyfacts as of latest extracted filing date 2026-04-29. Source: https://data.sec.gov/api/xbrl/companyfacts/CIK0000766704.json.

Flow metrics use discrete quarter-length periods from 10-Q/10-Q/A filings. Q4 revenue and net income are derived only when annual FY and nine-month YTD facts exist for the same fiscal year; derived Q4 values are labeled. EPS Q4 is not derived.

QuarterEnd DateRevenueNet IncomeDiluted EPSMethod
2022-Q22022-06-300.20reported discrete quarter
2022-Q32022-09-30-0.01reported discrete quarter
2023-Q12023-03-310.05reported discrete quarter
2023-Q22023-06-301,665,478,000106,342,0000.20reported discrete quarter
2023-Q32023-09-301,662,013,000134,722,0000.24reported discrete quarter
2023-Q42023-12-311,749,775,00088,440,000derived Q4 = FY annual - nine-month YTD
2024-Q12024-03-311,859,741,000131,634,0000.22reported discrete quarter
2024-Q22024-06-301,824,884,000260,670,0000.42reported discrete quarter
2024-Q32024-09-302,055,663,000456,800,0000.73reported discrete quarter
2024-Q42024-12-312,250,830,000123,753,000derived Q4 = FY annual - nine-month YTD
2025-Q12025-03-312,423,087,000257,266,0000.40reported discrete quarter
2025-Q22025-06-302,548,244,000304,618,0000.45reported discrete quarter
2025-Q32025-09-302,685,692,000282,186,0000.41reported discrete quarter
2025-Q42025-12-313,181,011,000117,767,000derived Q4 = FY annual - nine-month YTD
2026-Q12026-03-313,351,926,000752,324,0001.02reported discrete quarter

Quarterly Charts

Macro Cross-References

Latest quarter (10-Q)

Latest 10-Q source: 0000766704-26-000021.

Extracted structurally from real Item 2 body heading to real Item 3/4 boundary. Published MD&A gate trimmed front/tail over-capture. Confidence: high. Filing date: 2026-04-29. Report date: 2026-03-31.

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

EXECUTIVE SUMMARY
Company Overview32
Business Strategy32
Key Transactions33
Key Performance Indicators, Trends and Uncertainties34
Corporate Governance36
LIQUIDITY AND CAPITAL RESOURCES
Sources and Uses of Cash36
Off-Balance Sheet Arrangements37
Contractual Obligations38
Capital Structure38
Supplemental Guarantor Information39
RESULTS OF OPERATIONS
Summary40
Seniors Housing Operating41
Triple-net43
Outpatient Medical44
Non-Segment/Corporate46
OTHER
Non-GAAP Financial Measures47
Critical Accounting Policies and Estimates53
Cautionary Statement Regarding Forward-Looking Statements54

31

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following discussion and analysis should be read together with the Consolidated Financial Statements and related Notes thereto included in Item 1 of this Quarterly Report on Form 10-Q. Other important factors are identified in our Annual Report on Form 10-K for the year ended December 31, 2025, including factors identified under the headings “Business,” “Risk Factors,” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations.”

We are structured as an umbrella partnership REIT under which substantially all of our business is conducted through Welltower OP LLC, the day-to-day management of which is exclusively controlled by Welltower Inc. Welltower Inc. has no material assets or liabilities other than its investment in Welltower OP LLC. Welltower OP LLC is generally the borrower under, and Welltower Inc. is the guarantor of, the unsecured notes described in Note 11 to our unaudited consolidated financial statements.

Unless stated otherwise or the context otherwise requires, references to “Welltower” mean Welltower Inc. and references to “Welltower OP” mean Welltower OP LLC. References to “we,” “us” and “our” mean collectively Welltower, Welltower OP and those entities/subsidiaries owned or controlled by Welltower and/or Welltower OP.

Executive Summary

Company Overview

Welltower Inc. (NYSE: WELL), a real estate investment trust (“REIT”) and S&P 500 company, is positioned at the center of the silver economy, focusing on rental housing for aging seniors across the United States, United Kingdom and Canada. Our portfolio predominantly consists of 2,500+ seniors and wellness housing communities that are positioned at the intersection of housing, healthcare and hospitality, creating vibrant communities for mature renters and older adults.

Welltower is the initial member and majority owner of Welltower OP, with an approximate ownership interest of 98.159% as of March 31, 2026. All of our property ownership, development and related business operations are conducted through Welltower OP and Welltower has no material assets or liabilities other than its investment in Welltower OP. Welltower issues equity from time to time, the net proceeds of which it is obligated to contribute as additional capital to Welltower OP. All debt including credit facilities, senior notes and secured debt is incurred by Welltower OP and its subsidiaries, and Welltower has fully and unconditionally guaranteed all existing senior unsecured notes.

The following table summarizes our consolidated portfolio for the three months ended March 31, 2026 (dollars in thousands):

Percentage ofNumber of
Type of PropertyNOI(1)NOIProperties
Seniors Housing Operating$775,01363.9%1,810
Triple-net384,30631.7%780
Outpatient Medical53,2994.4%68
Totals$1,212,618100.0%2,658
(1) Represents consolidated NOI and excludes our share of investments in unconsolidated entities. Entities in which we have a joint venture with a minority partner are shown at 100% of the joint venture amount. See “Non-GAAP Financial Measures” below for additional information and reconciliation.

Business Strategy

Our primary objectives are to protect stockholder capital and enhance stockholder value. We seek to pay consistent cash dividends to stockholders and create opportunities to increase dividend payments to stockholders through annual increases in NOI and portfolio growth. To meet these objectives, we invest across the full spectrum of seniors housing and healthcare real estate and diversify our investment portfolio by property type, relationship and geographic location.

Substantially all of our revenues are derived from operating lease rentals, resident fees and services, interest earned on outstanding loans receivable and interest earned on short-term deposits. These items represent our primary sources of liquidity to fund distributions and depend upon the continued ability of our obligors to make contractual rent and interest payments to us and the profitability of our operating properties. To the extent that our obligors/partners experience operating difficulties and become unable to generate sufficient cash to make payments or operating distributions to us, there could be a material adverse impact on our consolidated results of operations, liquidity and/or financial condition.

To mitigate this risk, we monitor our investments through a variety of methods determined by the type of property. Our asset management process for seniors housing properties generally includes review of monthly financial statements and other operating data for each property, review of obligor/partner creditworthiness, property inspections and review of covenant compliance relating to licensure, real estate taxes, letters of credit and other collateral. Our external property management partners manage and monitor the Outpatient Medical Portfolio. We evaluate the operating environment in each property’s market to determine the likely trend in operating performance of the facility. When we identify unacceptable trends, we seek to mitigate, eliminate or transfer the risk. Through these efforts, we generally aim to intervene at an early stage to address any negative trends, and in so doing, support both the collectability of revenue and the value of our investment.

32

Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations

In addition to our asset management and research efforts, we aim to structure our relevant investments to mitigate payment risk. Operating leases and loans are normally credit enhanced by guarantees and/or letters of credit. Also, operating leases are typically structured as master leases and loans are generally cross-defaulted and cross-collateralized with other real estate loans, operating leases or agreements between us and the obligor and its affiliates.

For the three months ended March 31, 2026, resident fees and services and rental income represented 83% and 14% of total revenues, respectively. Substantially all of our operating leases are designed with escalating rent structures. Leases with fixed annual rental escalators are generally recognized on a straight-line basis over the initial lease period, subject to a collectability assessment. Rental income related to leases with contingent rental escalators is generally recorded based on the contractual cash rental payments due for the period. Our yield on loans receivable depends upon a number of factors, including the stated interest rate, the average principal amount outstanding during the term of the loan and any interest rate adjustments.

Our primary sources of cash include resident fees and services revenue, rental income and interest receipts, interest earned on short-term deposits, borrowings under our unsecured revolving credit facility and commercial paper program, issuances of debt and equity securities, including through our ATM Program (as defined below), proceeds from investment dispositions and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including acquisitions, capital expenditures, construction advances and transaction costs), loan advances, property operating expenses, general and administrative expenses and other expenses. Depending upon the availability and cost of external capital, we believe our liquidity is sufficient to fund these uses of cash.

We also continuously evaluate opportunities to finance future investments. New investments are generally funded from temporary borrowings under our unsecured revolving credit facility and commercial paper program, equity issuances, internally generated cash and the proceeds from investment dispositions.

Depending upon market conditions, we believe that new investments will be available in the future with spreads over our cost of capital that will generate appropriate returns to our stockholders. It is also likely that investment dispositions may occur in the future and we expect to reinvest the proceeds from any investment dispositions in new investments. In the event that investment dispositions exceed new investments, our revenues and cash flows from operations could be adversely affected. To the extent that new investment requirements exceed our available cash on-hand, we expect to borrow under our unsecured revolving credit facility and commercial paper program or issue debt or equity securities, including through our ATM Program. At March 31, 2026, we had $4,703,775,000 of cash and cash equivalents, $115,518,000 of restricted cash and $6,250,000,000 of available borrowing capacity under our unsecured revolving credit facility.

Key Transactions

Capital The following summarizes key capital transactions that occurred during the three months ended March 31, 2026:

•During the three months ended March 31, 2026, we sold 7,682,832 shares of common stock under the ATM Program generating gross proceeds of approximately $1,557,174,000.

•In March 2026, we closed on an amended $6,250,000,000 senior unsecured revolving credit line, which achieves a 15 bps improvement in pricing. The revolving facility is comprised of a $4,250,000,000 tranche that matures on March 6, 2030 and a $2,000,000,000 tranche that matures on July 24, 2029. We have an ability, on an uncommitted basis, to upsize the revolving facility by up to an additional $1,250,000,000. The amended facility increases our total available credit facilities to $7,500,000,000. Concurrent with the closing, we repaid our existing $1,000,000,000 USD term loan and $250,000,000 CAD term loan with cash on hand.

•In March 2026, we increased the size of the commercial paper program to $3,000,000,000.

Investments The following summarizes our property acquisitions and joint venture investments completed during the three months ended March 31, 2026 (dollars in thousands):

PropertiesBook Amount(1)Capitalization Rates(2)
Seniors Housing Operating22$993,8087.7%
Triple-net7191,0647.3%
Outpatient Medical199,0805.7%
Totals30$1,283,9527.4%
(1) Represents amounts recorded in net real estate investments including fair value adjustments pursuant to U.S. GAAP. See Note 3 to our unaudited consolidated financial statements for additional information.
(2) Represents annualized contractual or projected NOI to be received in cash divided by investment amounts.

33

Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations

Significan

[Excerpt truncated for page length; source filing is linked above.]

Latest 10-K MD&A

Extracted structurally from real Item 7 body heading to real Item 7A/8 boundary. Confidence: high. Filing date: 2026-02-12. Report date: 2025-12-31.

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

EXECUTIVE SUMMARY
Company Overview54
Business Strategy54
Key Transactions55
Key Performance Indicators, Trends and Uncertainties56
Corporate Governance58
LIQUIDITY AND CAPITAL RESOURCES
Sources and Uses of Cash58
Off-Balance Sheet Arrangements59
Contractual Obligations59
Capital Structure60
Supplemental Guarantor Information61
RESULTS OF OPERATIONS
Summary61
Seniors Housing Operating63
Triple-net65
Outpatient Medical67
Non-Segment/Corporate68
OTHER
Non-GAAP Financial Measures69
Critical Accounting Policies and Estimates76

53

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following discussion and analysis is based primarily on the consolidated financial statements of Welltower Inc. presented in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for the periods presented and should be read together with the notes thereto contained in this Annual Report on Form 10-K. Other important factors are identified in “Item 1 — Business” and “Item 1A — Risk Factors” above.

We are structured as an umbrella partnership REIT under which substantially all of our business is conducted through Welltower OP LLC, the day-to-day management of which is exclusively controlled by Welltower Inc. Welltower Inc. has no material assets or liabilities other than its investment in Welltower OP LLC. Welltower OP LLC is generally the borrower under, and Welltower Inc. is the guarantor of, the unsecured notes described in Note 11 to our consolidated financial statements.

Unless stated otherwise or the context otherwise requires, references to “Welltower” mean Welltower Inc. and references to “Welltower OP” mean Welltower OP LLC. References to “we,” “us” and “our” mean collectively Welltower, Welltower OP and those entities/subsidiaries owned or controlled by Welltower and/or Welltower OP.

Executive Summary

Company Overview

Welltower Inc. (NYSE:WELL), a real estate investment trust (“REIT”) and S&P 500 company, is positioned at the center of the silver economy, focusing on rental housing for aging seniors across the United States, United Kingdom and Canada. Our portfolio predominantly consists of 2,500+ seniors and wellness housing communities that are positioned at the intersection of housing and hospitality, creating vibrant communities for mature renters and older adults.

Welltower is the initial member and majority owner of Welltower OP, with an approximate ownership interest of 98.378% as of December 31, 2025. All of our property ownership, development and related business operations are conducted through Welltower OP and Welltower has no material assets or liabilities other than its investment in Welltower OP. Welltower issues equity from time to time, the net proceeds of which it is obligated to contribute as additional capital to Welltower OP. All debt including credit facilities, senior notes and secured debt is incurred by Welltower OP and its subsidiaries, and Welltower has fully and unconditionally guaranteed all existing senior unsecured notes.

The following table summarizes our consolidated portfolio for the year ended December 31, 2025 (dollars in thousands):

Percentage ofNumber of
Type of PropertyNOI(1)NOIProperties
Seniors Housing Operating$2,289,47557.2%1,786
Triple-net1,163,81329.1%811
Outpatient Medical548,69913.7%129
Totals$4,001,987100.0%2,726

(1) Represents consolidated net operating income (“NOI”) and excludes our share of investments in unconsolidated entities. Entities in which we have a joint venture with a minority partner are shown at 100% of the joint venture amount. Non-segment/Corporate NOI, which includes the loan portfolio, is excluded. See Non-GAAP Financial Measures for additional information and reconciliation.

Business Strategy

Our primary objectives are to protect stockholder capital and enhance stockholder value. We seek to pay consistent cash dividends to stockholders and create opportunities to increase dividend payments to stockholders through annual increases in NOI and portfolio growth. To meet these objectives, we invest across the full spectrum of seniors housing and healthcare real estate and diversify our investment portfolio by property type, relationship and geographic location.

Substantially all of our revenues are derived from operating lease rentals, resident fees and services, interest earned on outstanding loans receivable and interest earned on short-term deposits. These items represent our primary sources of liquidity to fund distributions and depend upon the continued ability of our obligors to make contractual rent and interest payments to us and the profitability of our operating properties. To the extent that our obligors/partners experience operating difficulties and become unable to generate sufficient cash to make payments or operating distributions to us, there could be a material adverse impact on our consolidated results of operations, liquidity and/or financial condition.

To mitigate this risk, we monitor our investments through a variety of methods determined by the type of property. Our asset management process for seniors housing properties generally includes review of monthly financial statements and other operating data for each property, review of obligor/partner creditworthiness, property inspections and review of covenant compliance relating to licensure, real estate taxes, letters of credit and other collateral. Our external property management partners manage and monitor the Outpatient Medical portfolio. We evaluate the operating environment in each property’s market to determine the likely trend in operating performance of the facility. When we identify unacceptable trends, we seek to mitigate, eliminate or transfer the risk. Through these efforts, we generally aim to intervene at an early stage to address any negative trends, and in so doing, support both the collectability of revenue and the value of our investment.

54

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

In addition to our asset management and research efforts, we aim to structure our relevant investments to mitigate payment risk. Operating leases and loans are normally credit enhanced by guarantees and/or letters of credit. Also, operating leases are typically structured as master leases and loans are generally cross-defaulted and cross-collateralized with other real estate loans, operating leases or agreements between us and the obligor and its affiliates.

For the year ended December 31, 2025, resident fees and services and rental income represented 78% and 18% of total revenues, respectively. Substantially all of our operating leases are designed with escalating rent structures. Leases with fixed annual rental escalators are generally recognized on a straight-line basis over the initial lease period, subject to a collectability assessment. Rental income related to leases with contingent rental escalators is generally recorded based on the contractual cash rental payments due for the period. Our yield on loans receivable depends upon a number of factors, including the stated interest rate, the average principal amount outstanding during the term of the loan and any interest rate adjustments.

Our primary sources of cash include resident fees and services revenue, rental income and interest receipts, interest earned on short-term deposits, borrowings under our unsecured revolving credit facility and commercial paper program, issuances of debt and equity securities including through our ATM Program (as defined below), proceeds from investment dispositions and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including acquisitions, capital expenditures, construction advances and transaction costs), loan advances, property operating expenses, general and administrative expenses and other expenses. Depending upon the availability and cost of external capital, we believe our liquidity is sufficient to fund these uses of cash.

We also continuously evaluate opportunities to finance future investments. New investments are generally funded from temporary borrowings under our unsecured revolving credit facility and commercial paper program, equity issuances, internally generated cash and the proceeds from investment dispositions.

Depending upon market conditions, we believe that new investments will be available in the future with spreads over our cost of capital that will generate appropriate returns to our stockholders. It is also likely that investment dispositions may occur in the future and we expect to reinvest the proceeds from any investment dispositions in new investments. In the event that investment dispositions exceed new investments, our revenues and cash flows from operations could be adversely affected. To the extent that new investment requirements exceed our available cash on-hand, we expect to borrow under our unsecured revolving credit facility and commercial paper program or issue debt or equity securities, including through our ATM Program. At December 31, 2025, we had $5,033,678,000 of cash and cash equivalents, $175,861,000 of restricted cash and $5,000,000,000 of available borrowing capacity under our unsecured revolving credit facility.

Key Transactions

Capital The following summarizes key capital transactions that occurred during the year ended December 31, 2025:

•In October 2025, we entered into the ATM Program pursuant to which we may offer and sell up to $7,500,000,000 of common stock, which replaced our prior equity distribution agreement dated March 28, 2025, allowing us to sell up to $7,500,000,000 of common stock (collectively, along with other previous agreements, referred to as the “ATM Programs”). During the year ended December 31, 2025, we sold 56,120,996 shares of common stock under our current and previous ATM Programs generating gross proceeds of approximately $8,949,394,000.

•In June 2025, we repaid our $1,250,000,000 4.0% senior unsecured notes at maturity. Additionally, we completed the issuance of $600,000,000 of 4.5% senior unsecured notes due 2030 and $650,000,000 of 5.125% senior unsecured notes due 2035.

•In August 2025, we completed a follow-on issuance of $400,000,000 of 4.5% senior unsecured notes due 2030 and $600,000,000 of 5.125% senior unsecured notes due 2035. These notes are fungible with and form a single series with the notes of the applicable series issued in June 2025.

•In October 2025, we issued $2,747,615,000 of Canadian-denominated unsecured term loans (approximately $1,959,967,000 based on the Canadian/U.S. Dollar exchange rates upon funding). The term loans mature on October 9, 2026, and bear interest at adjusted CORRA plus 0.30%.

•During the year ended December 31, 2025, we extinguished $346,964,000 of secured debt at a blended average interest rate of 5.16%.

•During the year ended December 31, 2025, we issued $4,871,000 of secured debt at a blended average interest rate of 3.89% and assumed $469,130,000 of secured debt at a blended average interest rate of 4.45%.

Investments The following summarizes our property acquisitions and joint venture investments completed during the year ended December 31, 2025 (dollars in thousands):

55

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

PropertiesBook Amount(1)Capitalization Rates(2)
Seniors Housing Operating624$12,618,0926.8%
Triple-net3246,521,78810.4%
Outpatient Medical124,1285.8%
Totals949$19,164,0088.1%

(1) Represents amounts recorded in net real estate investments including fair value adjustments pursuant to U.S. GAAP. See Note 3 to our consolidated financial statements for additional information.

(2) Represents annualized contractual or projected NOI to be received in cash divided by investment amounts.

Dispositions The following summarizes property dispositions completed during the year ended December 31, 2025 (dollars in thousands):

PropertiesProceeds(1)Book Amount(2)Capitalization Rates(3)
Seniors Housing Operating(4)37$556,859$499,5099.0%
Triple-net(5)581,152,913696,0187.2%
Outpatient Medical2424,930,4253,904,0366.3%
Totals337$6,640,197$5,099,5636.7%

(1) Represents net proceeds received upon disposition, excluding non-cash consideration.

(2) Represents carrying value of net real estate assets at time of disposition. See Note 5 to our consolidated financial statements for additional information.

(3) Represents annualized contractual income that was being received in cash at date of disposition divided by stated purchase price.

(4) Includes the disposition of unconsolidated equity method investments that owned 16 Seniors Housing Operating properties.

(5) Excludes $342,201,000 of net real property derecognized related to 30 properties upon the reclassification from operating to sales-type leases and includes $465,198,000 of net real property derecognized related to 40 properties upon reclassification from operating to sales-type leases for which the underlying properties were sold and the sales-type lease terminated during the year.

Amica Senior Lifestyles Acquisition

In March 2025, we announced a definitive agreement to acquire a portfolio of 38 seniors housing communities and nine development parcels for aggregate consideration of C$4.6 billion. The portfolio will be operated by Amica Senior Lifestyles and is expected to close in early 2026, subject to customary closing conditions and regulatory approvals.

Dividends Our Board of Directors declared a cash dividend for the quarter ended December 31, 2025 of $0.74 per share. On March 10, 2026, we will pay our 219th consecutive quarterly cash dividend to stockholders of record on February 25, 2026.

Key Performance Indicators, Trends and Uncertainties

We utilize several key performance indicators to evaluate the various aspects of our business. These indicators are discussed below and relate to operating performance, credit strength and concentration risk. Management uses these key performance indicators to facilitate internal and external comparisons to our historical operating results, in making operating decisions and for budget planning purposes.

Operating Performance We believe that net income and net income attributable to common stockholders (“NICS”) as reflected in the Consolidated Statements of Comprehensive Income are the most appropriate earnings measures. Other useful supplemental measures of our operating performance include funds from operations attributable to common stockholders (“FFO”) and consolidated net operating income (“NOI”); however, these supplemental measures are not defined by U.S. GAAP. Please refer to the section entitled “Non-GAAP Financial Measures” for further discussion and reconciliations. These earnings measures are widely used by investors and analysts in the valuation, comparison and investment recommendations of companies.

The following table reflects the recent historical trends of our operating performance measures for the periods presented (in thousands):

Year Ended December 31,
202520242023
Net income$961,837$972,857$358,139
Net income attributable to common stockholders936,845951,680340,094
Funds from operations attributable to common stockholders1,817,9522,323,4331,763,227
Consolidated net operating income4,349,9533,160,9072,690,219

Credit Strength We measure our credit strength both in terms of leverage ratios and coverage ratios. The leverage ratios indicate how much of our balance sheet capitalization is related to long-term debt, net of cash and restricted cash. The coverage ratios indicate our ability to service interest and fixed charges (interest and secured debt principal amortization). We expect to maintain capitalization ratios and coverage ratios sufficient to maintain a capital structure consistent with our current profile. The coverage ratios are based on earnings before interest, taxes, depreciation and amortization (“EBITDA”) and adjusted

56

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

earnings before interest, taxes, depreciation and amortization (“Adjusted EBITDA”). Please refer to the section entitled “Non-GAAP Financial Measures” for further discussion and reconciliation of these measures. Leverage ratios and coverage ratios are widely used by investors, analysts and rating agencies in the valuation, comparison, investment recommendations and rating of companies. The following table reflects the recent historical trends for our credit strength measures for the periods presented:

Year Ended December 31,
202520242023
Net debt to book capitalization ratio25.2%26.8%34.3%
Net debt to undepreciated book capitalization ratio21.3%21.6%27.8%
Net debt to enterprise ratio10.0%12.9%20.9%
Interest coverage ratio5.82x5.39x3.74x
Fixed charge coverage ratio5.28x4.99x3.44x
Adjusted interest coverage ratio6.57x5.34x3.95x
Adjusted fixed charge coverage ratio5.97x4.95x3.64x

Concentration Risk We evaluate our concentration risk in terms of NOI by property mix, relationship mix and geographic mix. Concentration risk is a valuable measure in understanding what portion of our NOI could be at risk if certain sectors were to experience downturns. Property mix measures the portion of our NOI that relates to our various property types and excludes interest income earned on our loan portfolio, which is classified as Non-segment/Corporate. Relationship mix measures the portion of our NOI that relates to our current top five relationships. Geographic mix measures the portion of our NOI that relates to our current top five states (or countries outside the U.S.).

The following table reflects our recent historical trends of concentration risk by NOI for the years indicated below:

Year Ended December 31,(1)
202520242023
Property mix:
Seniors Housing Operating57%54%45%
Triple-net29%27%34%
Outpatient Medical14%19%21%
Relationship mix:
Cogir Management Corporation8%7%4%
Care UK5%3%1%
Sunrise Senior Living5%5%6%
Integra Healthcare Properties4%7%8%
Oakmont Management Group4%4%4%
Remaining74%74%77%
Geographic mix:
United Kingdom15%11%9%
Texas11%8%8%
California10%11%12%
Canada7%6%6%
Florida6%8%6%
Remaining51%56%59%

(1) Excludes our share of investments in unconsolidated entities. Entities in which we have a joint venture with a minority partner are shown at 100% of the joint venture amount.

We evaluate our key performance indicators in conjunction with current expectations to determine if historical trends are indicative of future results. Our expected results may not be achieved, and actual results may differ materially from our expectations. Factors that may cause actual results to differ from expected results are described in more detail in “Item 1 — Business — Cautionary Statement Regarding Forward-Looking Statements” and “Item 1A — Risk Factors” and other sections of this Annual Report on Form 10-K. Management regularly monitors economic and other factors to develop strategic and tactical plans designed to improve performance and maximize our competitive position. Our ability to achieve our financial objectives is dependent upon our ability to effectively execute these plans and to appropriately respond to emerging economic and company-specific trends. Please refer to “Item 1 — Business,” “Item 1A — Risk Factors” in this Annual Report on Form 10-K for further discussion of these risk factors.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Corporate Governance

Maintaining investor confidence and trust is important in today’s business environment. Our Board of Directors and management are strongly committed to policies and procedures that reflect the highest level of ethical business practices. Our corporate governance guidelines provide the framework for our business operations and emphasize our commitment to increase stockholder value while meeting all applicable legal requirements. These guidelines meet the listing standards adopted by the New York Stock Exchange and are available on the on our website at www.welltower.com/investors/governance. The information on our website is not incorporated by reference in this Annual Report on Form 10-K, and our web address is included as an inactive textual reference only.

Liquidity and Capital Resources

Sources and Uses of Cash

Our primary sources of cash include resident fees and services, rent and interest receipts, interest earned on short-term deposits, borrowings under our unsecured revolving credit facility and commercial paper program, issuances of debt and equity securities, proceeds from investment dispositions and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including acquisitions, capital expenditures, construction advances and transaction costs), loan advances, property operating expenses, general and administrative expenses and other expenses. Depending upon the availability and cost of external capital, we believe our liquidity is sufficient to fund these uses of cash. These sources and uses of cash are reflected in our Consolidated Statements of Cash Flows and are discussed in further detail below. The following is a summary of our sources and uses of cash flows for the periods presented (in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20252024$%2023$%$%
Cash, cash equivalents and restricted cash at beginning of period$3,711,457$2,076,083$1,635,37479%$722,292$1,353,791187%$2,989,165414%
Net cash provided from (used in):
Operating activities2,881,6772,256,421625,25628%1,601,861654,56041%1,279,81680%
Investing activities(10,512,749)(5,514,681)(4,998,068)91%(5,707,742)193,061-3%(4,805,007)84%
Financing activities8,999,7604,905,3514,094,40983%5,448,647(543,296)-10%3,551,11365%
Effect of foreign currency translation129,394(11,717)141,111n/a11,025(22,742)n/a118,3691,074%
Cash, cash equivalents and restricted cash at end of period$5,209,539$3,711,457$1,498,08240%$2,076,083$1,635,37479%$3,133,456151%

Operating Activities Please see “Results of Operations” for discussion of net income fluctuations. For the years ended December 31, 2025, 2024 and 2023, cash flows provided from operations exceeded cash distributions to stockholders.

Investing Activities The changes in net cash provided from/used in investing activities are primarily attributable to net changes in real property investments and dispositions, loans receivable and investments in unconsolidated entities, which are summarized above in “Key Transactions.” Please refer to Notes 3 and 5 of our consolidated financial statements for additional information. The following is a summary of cash used in non-acquisition capital improvement activities for the periods presented (in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20252024$%2023$%$%
New development$437,731$827,900$(390,169)-47%$1,014,935$(187,035)-18%$(577,204)-57%
Recurring capital expenditures, tenant improvements and lease commissions374,457290,83283,62529%199,35991,47346%175,09888%
Renovations, redevelopments and other capital improvements675,806566,714109,09219%318,323248,39178%357,483112%
Total$1,487,994$1,685,446$(197,452)-12%$1,532,617$152,82910%$(44,623)-3%

The change in new development is primarily due to the number and size of construction projects ongoing during the relevant periods. Renovations, redevelopments and other capital improvements include expenditures to maximize property value, increase net operating income, maintain a market-competitive position and/or achieve property stabilization. The increase in renovations, redevelopments and other capital improvements is due primarily to portfolio growth.

Financing Activities The changes in net cash provided from/used in financing activities are primarily attributable to changes related to our long-term debt arrangements, the issuances of common stock and dividend payments. Financing activities that occurred during the year ended December 31, 2025 are summarized above in “Key Transactions.” Please also refer to Notes 10, 11 and 14 to our consolidated financial statements for additional information.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

In January 2024, we repaid our $400,000,000 4.5% senior unsecured notes at maturity. In March 2024, we repaid our $950,000,000 3.625% senior unsecured notes at maturity.

In July 2024, we issued $1,035,000,000 aggregate principal amount of 3.125% exchangeable senior unsecured notes maturing July 15, 2029.

Also in July 2024, we closed on an expanded $5,000,000,000 unsecured revolving credit facility, which replaced our $4,000,000,000 existing line of credit. The new facility is comprised of a $3,000,000,000 revolving line of credit maturing in June 2028 that can be extended for an additional year and a $2,000,000,000 revolving line of credit maturing in June 2029. Please also refer to Note 10 for additional information.

During the year ended December 31, 2024, we sold 70,419,530 shares of common stock under our ATM Programs, generating gross proceeds of approximately $7,452,108,000.

See “Key Transactions” for a description of 2025 financing activities.

Foreign Currency Translation The change in cash from foreign currency translation during the twelve months ended December 31, 2025 is primarily due to the mark-to-market adjustment of Canadian dollar funds held by Canadian subsidiaries to pre-fund the Amica Senior Lifestyles transaction. Please refer to Note 3 of our consolidated financial statements for additional information.

Off-Balance Sheet Arrangements

At December 31, 2025, we had investments in unconsolidated entities with our ownership generally ranging from 8% to 95%. We use financial derivative instruments to hedge interest rate and foreign currency exchange rate exposure. At December 31, 2025, we had 23 outstanding letter of credit obligations. Please see Notes 8, 12 and 13 to our consolidated financial statements for additional information.

We have entered into put-call agreements with third parties in conjunction with certain development projects. Under these agreements, we can initiate a call right or the third party can initiate a put right upon certain conditions being met, which would result in the acquisition of the related property by us, for which we currently have no ownership interest. If all conditions had been met under these agreements as of December 31, 2025, and the put or call rights for each investment had been triggered, the amount payable by us to acquire these properties would have been $375,660,000.

Contractual Obligations

The following table summarizes our payment requirements under contractual obligations as of December 31, 2025 (in thousands):

Payments Due by Period
Contractual ObligationsTotal20262027-20282029-2030Thereafter
Senior unsecured notes and term credit facilities:(1)
U.S. Dollar senior unsecured notes$11,620,000$700,000$2,285,000$3,835,000$4,800,000
Canadian Dollar senior unsecured notes(2)218,760218,760
Pounds Sterling senior unsecured notes(2)1,411,725739,475672,250
U.S. Dollar term credit facility1,089,8991,015,00074,899
Canadian Dollar term credit facility(2)2,185,8612,003,561182,300
Secured debt:(1,2)
Consolidated2,573,080246,296547,273579,5251,199,986
Unconsolidated665,44530,570165,61524,071445,189
Other financial obligations(3)260,0271,6263,4143,811251,176
Contractual interest obligations:(4)
Senior unsecured notes and term loans(2)3,587,518620,219938,886638,0411,390,372
Consolidated secured debt(2)690,189101,500167,063113,959307,667
Unconsolidated secured debt(2)163,91635,38459,76650,72318,043
Other financial obligations(3)1,505,77720,08539,89839,5011,406,293
Financing lease liabilities(5)1,434,12929,74057,44557,4031,289,541
Operating lease liabilities(5)3,102,455116,886234,691233,9712,516,907
Purchase obligations(6)564,565399,449151,77942112,916
Total contractual obligations$31,073,346$4,305,316$6,806,365$5,651,325$14,310,340

(1) Amounts represent principal amounts due and do not reflect unamortized premiums/discounts or other fair value adjustments as reflected on the Consolidated Balance Sheets.

(2) Based on foreign currency exchange rates in effect as of the balance sheet date.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

(3) See Note 11 to our consolidated financial statements for additional information.

(4) Based on variable interest rates in effect as of December 31, 2025.

(5) See Note 6 to our consolidated financial statements for additional information.

(6) See Note 13 to our consolidated financial statements for additional information. Excludes amounts related to asset acquisitions under contract that have not yet closed as of December 31, 2025.

Capital Structure

Please refer to “Credit Strength” above for a discussion of our leverage and coverage ratio trends. Our debt agreements contain various covenants, restrictions and events of default. Certain agreements require us to maintain financial ratios and minimum net worth and impose certain limits on our ability to incur indebtedness, create liens and make investments or acquisitions. As of December 31, 2025, we were in compliance in all material respects with the covenants under our debt agreements. None of our debt agreements contain provisions for acceleration which could be triggered by our debt ratings. However, under our primary unsecured credit facility, the ratings on our senior unsecured notes are used to determine the fees and interest charged. We plan to manage the company to maintain compliance with our debt covenants and with a capital structure consistent with our current profile. Any downgrades in terms of ratings or outlook by any or all of the rating agencies could have a material adverse impact on our cost and availability of capital, which could have a material adverse impact on our consolidated results of operations, liquidity and/or financial condition.

On March 28, 2025, Welltower and Welltower OP jointly filed with the SEC an open-ended automatic or “universal” shelf registration statement on Form S-3 (the “New Registration Statement”) covering an indeterminate amount of future offerings of Welltower’s debt securities, common stock, preferred stock, depositary shares, guarantees of debt securities issued by Welltower OP, warrants and units and Welltower OP’s debt securities and guarantees of debt securities issued by Welltower. In connection with the filing of the New Registration Statement, on March 28, 2025, Welltower filed with the SEC five prospectus supplements, as described below. On March 28, 2025, Welltower also filed with the SEC a registration statement in connection with its enhanced dividend reinvestment plan (“DRIP”) under which it may issue up to 15,000,000 shares of common stock. As of February 6, 2026, 15,000,000 shares of common stock remained available for issuance under the DRIP registration statement.

The first prospectus supplement filed in connection with the New Registration Statement related to the ATM Program (as defined below). On March 28, 2025, Welltower and Welltower OP entered into an equity distribution agreement with (i) BofA Securities, Inc., BBVA Securities Inc., BMO Capital Markets Corp., BNP Paribas Securities Corp., BNY Mellon Capital Markets, LLC, Barclays Capital Inc., Capital One Securities, Inc., Citigroup Global Markets Inc., Citizens JMP Securities, LLC, Credit Agricole Securities (USA) Inc., Deutsche Bank Securities Inc., Goldman Sachs & Co. LLC, Huntington Securities, Inc., Jefferies LLC, J.P. Morgan Securities LLC, KeyBanc Capital Markets Inc., Loop Capital Markets LLC, Mizuho Securities USA LLC, Morgan Stanley & Co. LLC, MUFG Securities Americas Inc., RBC Capital Markets, LLC, Regions Securities LLC, Scotia Capital (USA) Inc., Synovus Securities, Inc., TD Securities (USA) LLC, Truist Securities, Inc. and Wells Fargo Securities, LLC as sales agents and forward sellers and (ii) the forward purchasers named therein relating to issuances, offers and sales from time to time of up to $7,500,000,000 aggregate amount of common stock of Welltower (together with the existing master forward sale confirmations relating thereto, the “ATM Program”). The ATM Program also allows Welltower to enter into forward sale agreements. On October 28, 2025, Welltower and Welltower OP entered into a new equity distribution agreement with the sales agents, forward sellers and forward purchasers described above, which renewed the ATM Program on substantially similar terms and, in connection therewith, terminated the March 2025 equity distribution agreement. As of February 6, 2026, we had $5,617,290,000 of remaining capacity under the ATM Program and there were no outstanding forward sales agreements. Depending upon market conditions, we anticipate issuing securities under our registration statements to invest in additional properties and to repay borrowings under our unsecured revolving credit facility and commercial paper program.

The second such prospectus supplement continued an offering that was previously covered by a prior registration statement relating to the registration and possible issuance of up to 23,471,419 shares of common stock of Welltower Inc. (the “Exchangeable Shares”) that may, under certain circumstances, be issuable upon exchange of the 2.750% exchangeable senior notes due 2028 or 3.125% exchangeable senior notes due 2029 of Welltower OP, and the resale from time to time by the recipients of such Exchangeable Shares.

The third prospectus supplement filed in connection with the New Registration Statement continued an offering that was previously covered by a prior registration statement relating to the registration and possible issuance of up to 390,590 shares of common stock of Welltower Inc. (the “DownREIT Shares”) that may be issued from time to time if, and to the extent that, certain holders of Class A units (the “DownREIT Units”) of HCN G&L DownREIT II LLC, a Delaware limited liability company (the “DownREIT”), tender such DownREIT Units for redemption by the DownREIT, and HCN DownREIT Member, LLC, a majority-owned indirect subsidiary of the Company (including its permitted successors and assigns, the “Managing Member”), or a designated affiliate of the Managing Member, elects to assume the redemption obligations of the DownREIT and to satisfy all or a portion of the redemption consideration by issuing DownREIT Shares to the holders instead of or in addition to paying a cash amount.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The fourth such prospectus supplement continued an offering that was previously covered by a prior registration statement relating to the registration and possible issuance of up to 238,868 shares of common stock of Welltower Inc. that may be issued from time to time if, and to the extent that, certain holders of Class A Common Units (the “OP Units”) of Welltower OP tender the OP Units for redemption by Welltower OP, and Welltower Inc. elects to assume the redemption obligations of Welltower OP and to satisfy all or a portion of the redemption consideration by issuing shares of its common stock to the holders instead of or in addition to paying a cash amount.

The fifth such prospectus supplement registered the offer and resale by the selling stockholder identified therein of up to 1,563,904 shares of common stock of Welltower Inc., which Welltower issued as consideration for its recent acquisition of certain properties.

On July 29, 2025 and October 28, 2025, Welltower filed prospectus supplements with the SEC to register the offer and resale by the selling stockholders identified therein of an aggregate of up to 1,385,517 shares of common stock of Welltower Inc., which Welltower issued as consideration for its recent acquisitions of certain properties.

On October 28, 2025, Welltower filed a prospectus supplement with the SEC relating to the registration and possible issuance of up to 4,542,926 shares of common stock of Welltower Inc. that may be issued from time to time if, and to the extent that, certain holders of the OP Units tender their OP Units for redemption by Welltower OP, and Welltower Inc. elects to assume the redemption obligations of Welltower OP and to satisfy all or a portion of the redemption consideration by issuing shares of its common stock to the holders instead of or in addition to paying a cash amount.

Supplemental Guarantor Information

Welltower OP has issued the unsecured notes described in Note 11 to our Consolidated Financial Statements. All unsecured notes are fully and unconditionally guaranteed by Welltower, and Welltower OP is 98.378% owned by Welltower as of December 31, 2025. Effective January 4, 2021, the SEC adopted amendments to the financial disclosure requirements applicable to registered debt offerings that include certain credit enhancements. We have adopted these new rules, which permits subsidiary issuers of obligations guaranteed by the parent to omit separate financial statements if the consolidated financial statements of the parent company have been filed, the subsidiary obligor is a consolidated subsidiary of the parent company, the guaranteed security is debt or debt-like, and the security is guaranteed fully and unconditionally by the parent. Accordingly, separate consolidated financial statements of Welltower OP have not been presented. Furthermore, Welltower and Welltower OP have no material assets, liabilities or operations other than financing activities and their investments in non-guarantor subsidiaries. Therefore, we meet the criteria in Rule 13-01 of Regulation S-X to omit the summarized financial information from our disclosures.

Results of Operations

Summary

Our primary sources of revenue include resident fees and services revenue, rental income, interest income and interest earned on short-term deposits. Our primary expenses include property operating expenses, depreciation and amortization, interest expense, general and administrative expenses and other expenses. We evaluate our business and make resource allocations on our three operating segments: Seniors Housing Operating, Triple-net and Outpatient Medical. The primary performance measures for our properties are NOI and same store NOI (“SSNOI”) and other supplemental measures include FFO and Adjusted EBITDA, which are further discussed below. Please see Non-GAAP Financial Measures for additional information and reconciliations related to these supplemental measures.

This section of this Form 10-K generally discusses 2025 and 2024 items and year-to-year comparisons between 2025 and 2024. Discussions of 2023 items and year-to-year comparisons between 2024 and 2023 that are not included in this Form 10-K can be found in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 of the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2024.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a summary of our results of operations for the periods presented (in thousands, except per share amounts):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20252024Amount%2023Amount%Amount%
Net income$961,837$972,857$(11,020)-1%$358,139$614,718172%$603,698169%
NICS936,845951,680(14,835)-2%340,094611,586180%596,751175%
FFO1,817,9522,323,433(505,481)-22%1,763,227560,20632%54,7253%
EBITDA3,691,5443,181,911509,63316%2,373,450808,46134%1,318,09456%
Adjusted EBITDA4,169,3473,151,8111,017,53632%2,509,003642,80826%1,660,34466%
NOI4,349,9533,160,9071,189,04638%2,690,219470,68817%1,659,73462%
Per share data (fully diluted):
Net income attributable to common stockholders (1)$1.39$1.57$(0.18)-11%$0.66$0.91138%$0.73111%
Funds from operations attributable to common stockholders$2.68$3.82$(1.14)-30%$3.40$0.4212%$(0.72)-21%
Interest coverage ratio5.82x5.39x0.43x8%3.74x1.65x44%2.08x56%
Fixed charge coverage ratio5.28x4.99x0.29x6%3.44x1.55x45%1.84x53%
Adjusted interest coverage ratio6.57x5.34x1.23x23%3.95x1.39x35%2.62x66%
Adjusted fixed charge coverage ratio5.97x4.95x1.02x21%3.64x1.31x36%2.33x64%
(1) Includes adjustment to the numerator for income (loss) attributable to OP unitholders.

The following table represents the changes in outstanding common stock for the period from January 1, 2023 to December 31, 2025 (in thousands):

Year Ended December 31,
202520242023Totals
Beginning balance635,289564,241490,508490,508
Redemption of OP Units and DownREIT Units1,5944953362,425
Option exercises3618458
ATM Program issuances56,12170,42053,301179,842
Equity issuances3,25920,12523,384
Other, net208115(33)290
Ending balance696,507635,289564,241696,507
Weighted average number of shares outstanding:
Basic665,639602,975515,629
Diluted679,521608,750518,701

A portion of our earnings is derived primarily from long-term investments with predictable rates of return. These investments are mainly financed with a combination of equity, senior unsecured notes, secured debt and borrowings under our primary unsecured credit facility. During inflationary periods, which generally are accompanied by rising interest rates, our ability to grow may be adversely affected because the yield on new investments may increase at a slower rate than new borrowing costs.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Seniors Housing Operating

The following is a summary of our results of operations for the Seniors Housing Operating segment for the years presented (in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20252024$%2023$%$%
Revenues:
Resident fees and services$8,452,996$6,027,149$2,425,84740%$4,753,804$1,273,34527%$3,699,19278%
Other income36,0998,31227,787334%9,743(1,431)-15%26,356271%
Total revenues8,489,0956,035,4612,453,63441%4,763,5471,271,91427%3,725,54878%
Property operating expenses6,199,6204,523,7801,675,84037%3,655,508868,27224%2,544,11270%
NOI(1)2,289,4751,511,681777,79451%1,108,039403,64236%1,181,436107%
Other expenses:
Depreciation and amortization1,550,0421,107,116442,92640%906,771200,34522%643,27171%
Interest expense72,43542,94929,48669%56,509(13,560)-24%15,92628%
Loss (gain) on extinguishment of debt, net6,1561,7114,445260%1,711n/a6,156n/a
Impairment of assets37,75785,564(47,807)-56%24,99960,565242%12,75851%
Other expenses192,70696,43596,271100%96,972(537)-1%95,73499%
1,859,0961,333,775525,32139%1,085,251248,52423%773,84571%
Income (loss) from continuing operations before income taxes and other items430,379177,906252,473142%22,788155,118681%407,591n/a
Income (loss) from unconsolidated entities(31,470)1,376(32,846)n/a(70,940)72,316102%39,47056%
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net53,776134,082(80,306)-60%68,29065,79296%(14,514)-21%
Income (loss) from continuing operations452,685313,364139,32144%20,138293,226n/a432,5472,148%
Net income (loss)452,685313,364139,32144%20,138293,226n/a432,547n/a
Less: Net income (loss) attributable to noncontrolling interests(36)(2,694)2,65899%(5,975)3,28155%5,93999%
Net income (loss) attributable to common stockholders$452,721$316,058$136,66343%$26,113$289,945n/a$426,6081,634%

(1) See Non-GAAP Financial Measures below.

Resident fees and services revenue, property operating expenses and depreciation and amortization for the year ended December 31, 2025 increased compared to the prior year primarily due to acquisitions. See Note 3 to our consolidated financial statements for descriptions of our acquisitions during 2025 and 2024, including the acquisitions of the Barchester and HC-One portfolios in October 2025 and the Care UK acquisition in October 2024. Additional drivers of the increase include construction conversions outpacing dispositions and the conversions of Triple-net properties to Seniors Housing Operating RIDEA structures throughout 2024. Additionally, our Seniors Housing Operating revenues are dependent on occupancy and rate growth, both of which have continued to steadily increase during 2025. Average occupancy is as follows:

Three Months Ended(1)
March 31,June 30,September 30,December 31,
202482.5%82.8%83.8%84.8%
202585.1%85.6%86.9%87.4%

(1) Average occupancy includes our minority ownership share related to unconsolidated properties and excludes the minority partners’ noncontrolling ownership share related to consolidated properties. Also excludes land parcels and properties under development.

The following is a summary of our SSNOI at Welltower’s share for the Seniors Housing Operating segment (in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2025December 31, 2024$%December 31, 2025December 31, 2024$%
SSNOI(1)$467,842$387,280$80,56220.8%$1,483,893$1,225,971$257,92221.0%

(1) Relates to 875 properties for the QTD Pool and 638 properties for the YTD Pool. Please see Non-GAAP Financial Measures below for additional information and reconciliations.

The increase in other income during the year ended December 31, 2025 is primarily related to the management fee earned for the investment management services provided for Seniors Housing Fund I LP during 2025.

During the year ended December 31, 2025, we recorded impairment charges of $37,757,000 related to ten properties. During the year ended December 31, 2024, we recorded impairment charges of $85,564,000 related to 18 properties.

Transaction costs related to asset acquisitions are capitalized as a component of the purchase price. The fluctuation in other expenses is primarily due to the timing of noncapitalizable transaction costs associated with acquisitions, including those associated with the Barchester, HC-One and Care UK business combinations referred to above. Changes in the gain on

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

dispositions of real estate and acquisition of noncontrolling interests, net are related to the volume and timing of property sales and the sales prices, which are further discussed in Note 5 to our consolidated financial statements.

During the year ended December 31, 2025, we completed Seniors Housing Operating construction conversions representing $937,300,000 or $343,333 per unit. The following is a summary of our consolidated Seniors Housing Operating construction projects in process, excluding expansions, overhead and capitalized interest (dollars in thousands):

As of December 31, 2025
Expected Conversion Year(1)PropertiesUnits/BedsAnticipated Remaining FundingConstruction in Progress Balance
2026181,904$116,865$374,274
2027171,569293,412193,572
2028528782,74930,130
TBD(2)663,083
Total46$661,059
(1) Properties expected to be converted in phases over multiple years are reflected in the last expected year.
(2) Represents projects for which a final budget or expected conversion date are not yet known.

Interest expense represents secured debt interest expense, which fluctuates based on the net effect and timing of assumptions, segment transitions, fluctuations in interest rates, fluctuations in foreign currency rates, extinguishments and principal amortizations. The fluctuations in loss (gain) on extinguishment of debt is primarily attributable to the volume of extinguishments and terms of the related secured debt.

The following is a summary of our Seniors Housing Operating segment property secured debt principal activity (in thousands):

Year Ended December 31,
202520242023
Beginning balance$2,042,583$1,955,048$1,701,939
Debt transferred27,084
Debt issued4,871197,930385,115
Debt assumed469,130427,725381,837
Debt extinguished(259,621)(303,081)(486,825)
Debt disposed(164,640)
Principal payments(55,255)(41,220)(47,672)
Effect of foreign currency translation43,027(56,263)20,654
Ending balance$2,244,735$2,042,583$1,955,048
Ending weighted average interest4.15%4.29%4.68%

A portion of our Seniors Housing Operating property investments are formed through partnership interests. Income (loss) from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. The fluctuation in income (loss) from unconsolidated entities during the year ended December 31, 2025 is primarily related to hypothetical liquidation at book value (“HLBV”) adjustments to our unconsolidated entities (refer Note 2 for additional information). Net income attributable to noncontrolling interests represents our partners’ share of net income (loss) related to joint ventures.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Triple-net

The following is a summary of our results of operations for the Triple-net segment for the years presented (in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20252024$%2023$%$%
Revenues:
Rental income$1,193,514$777,297$416,21754%$814,751$(37,454)-5%$378,76346%
Interest income2,1118,167(6,056)-74%1,3696,798497%74254%
Other income1,4173,307(1,890)-57%70,986(67,679)-95%(69,569)-98%
Total revenues1,197,042788,771408,27152%887,106(98,335)-11%309,93635%
Property operating expenses33,22940,722(7,493)-18%42,194(1,472)-3%(8,965)-21%
NOI(1)1,163,813748,049415,76456%844,912(96,863)-11%318,90138%
Other expenses:
Depreciation and amortization318,352258,83059,52223%231,02827,80212%87,32438%
Interest expense15,6326,9188,714126%(65)6,983n/a15,697n/a
Loss (gain) on derivatives and financial instruments, net12(12)-100%98(86)-88%(98)-100%
Provision for loan losses, netn/a297(297)-100%(297)-100%
Impairment of assets38,2905,65832,632577%11,098(5,440)-49%27,192245%
Other expenses3,60510,793(7,188)-67%5,0605,733113%(1,455)-29%
375,879282,21193,66833%247,51634,69514%128,36352%
Income (loss) from continuing operations before income taxes and other items787,934465,838322,09669%597,396(131,558)-22%190,53832%
Income (loss) from unconsolidated entities883(17,554)18,437105%7,158(24,712)-345%(6,275)-88%
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net492,282309,453182,82959%259309,194n/a492,023n/a
Income (loss) from continuing operations1,281,099757,737523,36269%604,813152,92425%676,286112%
Net income (loss)1,281,099757,737523,36269%604,813152,92425%676,286112%
Less: Net income (loss) attributable to noncontrolling interests9,44219,764(10,322)-52%21,804(2,040)-9%(12,362)-57%
Net income (loss) attributable to common stockholders$1,271,657$737,973$533,68472%$583,009$154,96427%$688,648118%

(1) See Non-GAAP Financial Measures below.

The increase in rental income is primarily related to acquisitions that occurred during the year ended December 31, 2025. See Note 3 to our consolidated financial statements for additional information. Additionally, during the year ended December 31, 2024, we recognized a write-off of straight-line rent receivable and unamortized lease incentive balances of $139,652,000 related to leases for which the collection of substantially all contractual lease payments was no longer deemed probable due primarily to agreements reached to convert Triple-net properties to Seniors Housing Operating RIDEA structures.

Certain of our leases contain annual rental escalators that are contingent upon changes in the Consumer Price Index and/or changes in the gross operating revenues of the tenant’s properties. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. If gross operating revenues at our facilities and/or the Consumer Price Index do not increase, a portion of our revenues may not continue to increase. For the year ended December 31, 2025, we had 59 leases with rental rate increases and a weighted average increase of 3.58%.

Interest income is primarily related to leases that were classified as sales-type leases in 2024 and 2025.

The following is a summary of our SSNOI at Welltower’s share for the Triple-net segment (in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2025December 31, 2024$%December 31, 2025December 31, 2024$%
SSNOI(1)$150,602$146,941$3,6612.5%$520,949$506,549$14,4002.8%

(1) Relates to 431 properties for the QTD Pool and 384 properties for the YTD Pool. Please see Non-GAAP Financial Measures below for additional information and reconciliations.

Depreciation and amortization fluctuates as a result of the acquisitions, dispositions and segment transitions of Triple-net properties. To the extent we acquire or dispose of additional properties in the future, our provision for depreciation and amortization will change accordingly.

During the year ended December 31, 2025, we recorded impairment charges of $38,290,000 related to eight properties. During the year ended December 31, 2024, we recorded impairment charges of $5,658,000 related to three properties.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Transaction costs related to asset acquisitions are capitalized as a component of purchase price. The fluctuation in other expenses is primarily due to noncapitalizable transaction costs from acquisitions and segment transitions. Changes in the gain on real estate dispositions and acquisitions of controlling interests, net are related to the volume and timing of property sales and the sales prices, which are further discussed in Note 5 to our consolidated financial statements.

Interest expense represents secured debt interest expense and related fees. The change in secured debt interest expense is due to the net effect and timing of assumptions, segment transitions, fluctuations in interest rates, extinguishments and principal amortizations. The following is a summary of our Triple-net secured debt principal activity for the periods presented (in thousands):

Year Ended December 31,
202520242023
Beginning balance$335,552$38,260$39,179
Debt transferred(27,084)
Debt assumed532,575
Debt extinguished(10,628)
Debt disposed(194,500)
Principal payments(7,207)(3,071)(919)
Ending balance$328,345$335,552$38,260
Ending weighted average interest3.44%3.44%4.39%

A portion of our Triple-net property investments were formed through partnerships. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. The increase in income from unconsolidated entities during the year ended December 31, 2025 is primarily related to a decrease in hypothetical liquidation at book value (“HLBV”) adjustments to our unconsolidated entities (refer Note 2 for additional information.) Net income attributable to noncontrolling interests represents our partners’ share of net income relating to those partnerships where we are the controlling partner.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Outpatient Medical

The following is a summary of our results of operations for the Outpatient Medical segment for the years presented (in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20252024$%2023$%$%
Revenues:
Rental income$774,421$792,981$(18,560)-2%$741,322$51,6597%$33,0994%
Other income7,5119,132(1,621)-18%9,167(35)%(1,656)-18%
Total revenues781,932802,113(20,181)-3%750,48951,6247%31,4434%
Property operating expenses233,233245,636(12,403)-5%231,95613,6806%1,2771%
NOI(1)548,699556,477(7,778)-1%518,53337,9447%30,1666%
Other expenses:
Depreciation and amortization216,474266,147(49,673)-19%263,3022,8451%(46,828)-18%
Interest expense7691,150(381)-33%10,543(9,393)-89%(9,774)-93%
Loss (gain) on extinguishment of debt, net3,0893,089n/a7(7)-100%3,082n/a
Impairment of assets45,2361,57143,665n/a1,571n/a45,236n/a
Other expenses2,5746481,926297%2,289(1,641)-72%28512%
268,142269,516(1,374)-1%276,141(6,625)-2%(7,999)-3%
Income (loss) from continuing operations before income taxes and other item280,557286,961(6,404)-2%242,39244,56918%38,16516%
Income (loss) from unconsolidated entities(764)5,046(5,810)-115%(549)5,595n/a(215)-39%
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net902,9858,076894,909n/a(651)8,727n/a903,636n/a
Income (loss) from continuing operations1,182,778300,083882,695294%241,19258,89124%941,586390%
Net income (loss)1,182,778300,083882,695294%241,19258,89124%941,586390%
Less: Net income (loss) attributable to noncontrolling interests1,9261,30761947%1,309(2)%61747%
Net income (loss) attributable to common stockholders$1,180,852$298,776$882,076295%$239,883$58,89325%$940,969392%

(1) See Non-GAAP Financial Measures below.

On August 14, 2025, we entered into a definitive agreement to sell a portfolio of 319 consolidated and unconsolidated outpatient medical properties for approximately $7.2 billion. The disposition will occur in tranches expected to close through mid-2026. As of December 31, 2025 we have disposed of 241 properties with a gross sales price of approximately $5,224,900,000 and gain on real estate dispositions of $881,413,000.

For the year ended December 31, 2025, rental income and property operating expenses decreased primarily due to the properties sold during the fourth quarter. Of our remaining leases, many contain annual rental escalators that are contingent upon changes in the Consumer Price Index. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. Our leases could renew above or below current rental rates, resulting in an increase or decrease in rental income in the future.

The decrease in depreciation and amortization is primarily attributable to the above mentioned disposition meeting the held for sale criteria. To the extent that we acquire, classify as held for sale or dispose of additional properties in the future, these amounts will change accordingly.

The following is a summary of our SSNOI at Welltower share for the Outpatient Medical segment (in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2025December 31, 2024$%December 31, 2025December 31, 2024$%
SSNOI(1)$23,778$23,223$5552.4%$83,298$81,245$2,0532.5%

(1) Relates to 104 properties for the QTD Pool and 102 properties for the YTD Pool. Please see Non-GAAP Financial Measures below for additional information and reconciliations.

During the year ended December 31, 2025, we recorded an impairment charge of $45,236,000 related to four properties. During the year ended December 31, 2024, we recorded impairment charges of $1,571,000 related to one property.

Transaction costs related to asset acquisitions are capitalized as a component of purchase price. The fluctuation in other expenses is primarily due to noncapitalizable transaction costs. Changes in the gains/losses on sales of properties are related to the volume and timing of property sales and the sales prices, which are further discussed in Note 5 to our consolidated financial statements.

During the year ended December 31, 2025, we completed construction conversions representing $336,742,000 or $549 per square foot. As of December 31, 2025, we have one consolidated Outpatient Medical construction project in process with a

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

construction in progress balance of $34,645,000, excluding overhead and capitalized interest. The final budget and expected conversion date for the project are not yet known.

Total interest expense represents secured debt interest expense. The change in secured debt interest expense is primarily due to the net effect and timing of assumptions, fluctuations in interest rates, extinguishments and principal amortizations. The following is a summary of our Outpatient Medical secured debt principal activity (in thousands):

Year Ended December 31,
202520242023
Beginning balance$89,088$229,137$388,836
Debt assumed46,741
Debt extinguished(87,343)(137,011)(200,955)
Principal payments(1,745)(3,038)(5,485)
Ending balance$$89,088$229,137
Ending weighted average interest%4.19%5.42%

A portion of our Outpatient Medical property investments were formed through partnerships. Income (loss) from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. Net income attributable to noncontrolling interests represents our partners’ share of net income or loss relating to those partnerships where we are the controlling partner.

Non-segment/Corporate

The following is a summary of our results of operations for the Non-segment/Corporate activities for the periods presented (in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20252024$%2023$%$%
Revenues:
Interest income$244,094$248,024$(3,930)-2%$166,985$81,03949%$77,10946%
Other income125,871116,7499,1228%69,86846,88167%56,00380%
Total revenues369,965364,7735,1921%236,853127,92054%133,11256%
Property operating expenses21,99920,0731,92610%18,1181,95511%3,88121%
NOI(1)347,966344,7003,2661%218,735125,96558%129,23159%
Other expenses:
Interest expense563,119523,24439,8758%540,859(17,615)-3%22,2604%
General and administrative expenses1,748,435235,4911,512,944642%179,09156,40031%1,569,344876%
Loss (gain) on derivatives and financial instruments, net22,407(27,899)50,306180%(2,218)(25,681)n/a24,625n/a
Loss (gain) on extinguishments of debt, net419(419)-100%419n/an/a
Provision for loan losses, net(9,416)10,125(19,541)-193%9,5126136%(18,928)-199%
Other expenses2,3169,583(7,267)-76%4,0205,563138%(1,704)-42%
Total expenses2,326,861750,9631,575,898210%731,26419,6993%1,595,597218%
Loss from continuing operations before income taxes and other items(1,978,895)(406,263)(1,572,632)-387%(512,529)106,26621%(1,466,366)-286%
Income (loss) from unconsolidated entities17,05410,6366,41860%10,889(253)-2%6,16557%
Income tax (expense) benefit7,116(2,700)9,816364%(6,364)3,66458%13,480212%
Loss from continuing operations(1,954,725)(398,327)(1,556,398)-391%(508,004)109,67722%(1,446,721)-285%
Net income (loss)(1,954,725)(398,327)(1,556,398)-391%(508,004)109,67722%(1,446,721)-285%
Less: Net income (loss) attributable to noncontrolling interests13,6602,80010,860388%9071,893209%12,753n/a
Net loss attributable to common stockholders$(1,968,385)$(401,127)$(1,567,258)-391%$(508,911)$107,78421%$(1,459,474)-287%

(1) See Non-GAAP Financial Measures below.

Other income is primarily due to interest earned on deposits. Property operating expenses primarily represent insurance costs related to our captive insurance company, which acts as a direct insurer of property level insurance coverage for our portfolio.

The following is a summary of our Non-segment/Corporate interest expense for the periods presented (in thousands):

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20252024$%2023$%$%
Senior unsecured notes$501,993$497,223$4,7701%$508,681$(11,458)-2%$(6,688)-1%
Unsecured credit facility and commercial paper program15,2836,2399,044145%6,977(738)-11%8,306119%
Loan expenses and other45,84319,78226,061132%25,201(5,419)-22%20,64282%
Totals$563,119$523,244$39,8758%$540,859$(17,615)-3%$22,2604%

The change in interest expense on senior unsecured notes is due to the net effect of issuances and extinguishments, as well as the movement in foreign exchange rates and related hedge activity. Please refer to Note 11 to the consolidated financial statements for additional information. The change in interest expense on our unsecured revolving credit facility and commercial paper program is due primarily to the net effect and timing of draws, paydowns and variable interest rate changes. Please refer to Note 10 of our consolidated financial statements for additional information regarding our unsecured revolving credit facility and commercial paper program. Loan expenses and other include the amortization of costs incurred in connection with senior unsecured notes issuances, as well as gains and losses resulting from the changes in fair value of foreign currency exchange contracts substantially offset by net revaluation impacts on foreign currency denominated balance sheet exposures.

General and administrative expenses as a percentage of consolidated revenues for the years ended December 31, 2025, 2024 and 2023 were 16.13%, 2.95% and 2.70%, respectively. During the three months ended December 31, 2025, we recognized $1,408,672,000 of stock compensation expense due to the new “Ten Year Executive Continuity and Alignment Program” granting awards to our named executive officers and other key employees. Please refer to Note 15 for additional information related to these grants.

The fluctuation in provision for loan losses, net is related to adjustments to reserve for loan losses under the current expected credit losses accounting standard.

Other expenses includes noncapitalizable legal expenses. The provision for income taxes primarily relates to state taxes, foreign taxes and taxes based on income generated by entities that are structured as taxable REIT subsidiaries.

Loss (gain) on derivatives and financial instruments, net is primarily attributable to the mark-to-market of the equity warrants received as part of the HC-One Group transactions that closed in 2021 and 2023. These warrants were settled in conjunction with the HC-One Group acquisition. Please refer to Notes 3 and 12 for additional information related to the acquisition and related warrants.

Net income attributable to noncontrolling interests represents our partners’ share of net income relating to those partnerships where we are the controlling partner. For the year ended December 31, 2025, the increase is primarily driven by increased ownership by outside investors in Welltower OP.

Other

Non-GAAP Financial Measures

We believe that net income and net income attributable to common stockholders, as defined by U.S. GAAP, are the most appropriate earnings measurements. However, we consider FFO, NOI, SSNOI, EBITDA and Adjusted EBITDA to be useful supplemental measures of our operating performance. Historical cost accounting for real estate assets in accordance with U.S. GAAP implicitly assumes that the value of real estate assets diminishes predictably over time as evidenced by the provision for depreciation. However, since real estate values have historically risen or fallen with market conditions, many industry investors and analysts have considered presentations of operating results for real estate companies that use historical cost accounting to be insufficient. In response, the National Association of Real Estate Investment Trusts (“NAREIT”) created funds from operations attributable to common stockholders (“FFO”) as a supplemental measure of operating performance for REITs that excludes historical cost depreciation from net income. FFO, as defined by NAREIT, means NICS, computed in accordance with U.S. GAAP, excluding gains (or losses) from sales of real estate and acquisitions of controlling interests, and impairment of depreciable assets, plus depreciation and amortization, and after adjustments for unconsolidated entities and noncontrolling interests.

NOI is used to evaluate the operating performance of our properties. We define NOI as total revenues, including tenant reimbursements, less property operating expenses. Property operating expenses represent costs associated with managing, maintaining, and servicing tenants for our properties. These expenses include, but are not limited to, property-related payroll and benefits, property management fees paid to managers, marketing, housekeeping, food service, maintenance, utilities, property taxes and insurance. General and administrative expenses represent general overhead costs that are unrelated to property operations and unallocable to the properties. These expenses include, but are not limited to, payroll and benefits related to corporate employees, professional services, office expenses and depreciation of corporate fixed assets. Same store NOI (“SSNOI”) is used to evaluate the operating performance of our properties using a consistent population which controls for changes in the composition of our portfolio. We believe the drivers of property level NOI for both consolidated properties and unconsolidated properties are generally the same and therefore, we evaluate SSNOI based on our ownership interest in each property (“Welltower Share”). To arrive at Welltower’s Share, NOI is adjusted by adding our minority ownership share related

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

to unconsolidated properties and by subtracting the minority partners’ noncontrolling ownership interests for consolidated properties. We do not control investments in unconsolidated properties and while we consider disclosures at Welltower Share to be useful, they may not accurately depict the legal and economic implications of our joint venture arrangements and should be used with caution. As used herein, same store is generally defined as those revenue-generating properties in the portfolio for the relevant year-over-year reporting periods. Acquisitions and development conversions are included in SSNOI five full quarters or eight full quarters after acquisition or being placed into service for the QTD Pool and the YTD Pool, respectively. Land parcels, loans and leased properties, as well as any properties sold or classified as held for sale during the respective periods are excluded from SSNOI. Redeveloped properties (including major refurbishments of a Seniors Housing Operating property where 20% or more of units are simultaneously taken out of commission for 30 days or more or Outpatient Medical properties undergoing a change in intended use) are excluded from SSNOI until five full quarters or eight full quarters post completion of the redevelopment for the QTD Pool and YTD Pool, respectively. Properties undergoing operator transitions and/or segment transitions are also excluded from SSNOI until five full quarters or eight full quarters post completion of the transition for the QTD Pool and YTD Pool, respectively. In addition, properties significantly impacted by force majeure, acts of God, or other extraordinary adverse events are excluded from SSNOI until five full quarters or eight full quarters after the properties are placed back into service for the QTD Pool and YTD Pool, respectively. SSNOI excludes non-cash NOI and includes adjustments to present consistent ownership percentages and to translate Canadian properties and U.K. properties using a consistent exchange rate. We believe NOI and SSNOI provide investors relevant and useful information because they measure the operating performance of our properties at the property level on an unleveraged basis. We use NOI and SSNOI to make decisions about resource allocations and to assess the property level performance of our portfolio.

EBITDA is defined as earnings (net income) before interest, taxes, depreciation and amortization. Adjusted EBITDA is defined as EBITDA excluding unconsolidated entities and including adjustments for stock-based compensation expense, provision for loan losses, gains/losses on extinguishment of debt, gains/losses on disposition of properties and acquisitions of controlling interests, impairment of assets, gains/losses on derivatives and financial instruments, other expenses, other impairment charges and other adjustments as deemed appropriate. We believe that EBITDA and Adjusted EBITDA, along with net income, are important supplemental measures because they provide additional information to assess and evaluate the performance of our operations. We primarily use these measures to determine our interest coverage ratio, which represents EBITDA and Adjusted EBITDA divided by total interest, and our fixed charge coverage ratio, which represents EBITDA and Adjusted EBITDA divided by fixed charges. Fixed charges include total interest and secured debt principal amortization. Covenants in our unsecured senior notes and primary credit facility contain financial ratios based on a definition of EBITDA and Adjusted EBITDA that is specific to those agreements. Our leverage ratios are defined as the proportion of net debt to total capitalization and include book capitalization, undepreciated book capitalization and enterprise value. Book capitalization represents the sum of net debt (defined as total long-term debt, excluding operating lease liabilities, less cash and cash equivalents and restricted cash), total equity and redeemable noncontrolling interests. Undepreciated book capitalization represents book capitalization adjusted for accumulated depreciation and amortization. Enterprise value represents book capitalization adjusted for the fair market value of our common stock.

Our supplemental reporting measures and similarly entitled financial measures are widely used by investors, equity and debt analysts and rating agencies in the valuation, comparison, rating and investment recommendations of companies. Management uses these financial measures to facilitate internal and external comparisons to our historical operating results and in making operating decisions. Additionally, the Board of Directors utilizes these measures to evaluate management performance. None of our supplemental measures represent net income or cash flow provided from operating activities as determined in accordance with U.S. GAAP and should not be considered as alternative measures of profitability or liquidity. Finally, the supplemental measures, as defined by us, may not be comparable to similarly entitled items reported by other real estate investment trusts or other companies.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The table below reflects the reconciliation of FFO to NICS, the most directly comparable U.S. GAAP measure, for the periods presented. Noncontrolling interest and unconsolidated entity amounts represent adjustments to reflect our share of depreciation and amortization, gains/loss on real estate dispositions and acquisitions of controlling interests, net and impairment of assets. Amounts are in thousands except for per share data.

Year Ended December 31,
FFO Reconciliation:202520242023
Net income attributable to common stockholders$936,845$951,680$340,094
Depreciation and amortization2,084,8681,632,0931,401,101
Impairment of assets121,28392,79336,097
Loss (gain) on real estate dispositions and acquisitions of controlling interests, net(1,449,043)(451,611)(67,898)
Noncontrolling interests(13,144)(30,812)(46,393)
Unconsolidated entities137,143129,290100,226
Funds from operations attributable to common stockholders$1,817,952$2,323,433$1,763,227
Average diluted shares outstanding:679,521608,750518,701
Per diluted share data:
Net income attributable to common stockholders(1)$1.39$1.57$0.66
Funds from operations attributable to common stockholders$2.68$3.82$3.40
(1) Includes adjustment to the numerator for income (loss) attributable to OP Unitholders.

The tables below reflects the reconciliation of consolidated NOI to net income, the most directly comparable U.S. GAAP measure, for the years presented (in thousands):

Year Ended December 31,
NOI Reconciliation:202520242023
Net income (loss)$961,837$972,857$358,139
Loss (gain) on real estate dispositions and acquisitions of controlling interests, net(1,449,043)(451,611)(67,898)
Loss (income) from unconsolidated entities14,29749653,442
Income tax expense (benefit)(7,116)2,7006,364
Other expenses201,201117,459108,341
Impairment of assets121,28392,79336,097
Provision for loan losses, net(9,416)10,1259,809
Loss (gain) on extinguishment of debt, net9,2452,1307
Loss (gain) on derivatives and financial instruments, net22,407(27,887)(2,120)
General and administrative expenses1,748,435235,491179,091
Depreciation and amortization2,084,8681,632,0931,401,101
Interest expense651,955574,261607,846
Consolidated net operating income (NOI)$4,349,953$3,160,907$2,690,219
NOI by segment:
Seniors Housing Operating$2,289,475$1,511,681$1,108,039
Triple-net1,163,813748,049844,912
Outpatient Medical548,699556,477518,533
Non-segment/Corporate347,966344,700218,735
Total NOI$4,349,953$3,160,907$2,690,219

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Quarterly NOI by Segment:
(in thousands)Three Months EndedYear Ended
March 31,June 30,September 30,December 31,December 31,
2025202420252024202520242025202420252024
Seniors Housing Operating:
Total revenues$1,867,871$1,361,737$1,975,732$1,395,373$2,070,115$1,514,022$2,575,377$1,764,329$8,489,095$6,035,461
Property operating expenses1,384,6841,019,3471,438,2771,034,9061,499,2151,135,8871,877,4441,333,6406,199,6204,523,780
Consolidated NOI$483,187$342,390$537,455$360,467$570,900$378,135$697,933$430,689$2,289,475$1,511,681
Triple-net:
Total revenues$255,030$222,943$273,754$142,082$286,637$228,649$381,621$195,097$1,197,042$788,771
Property operating expenses8,81810,8178,65210,4958,2279,3457,53210,06533,22940,722
Consolidated NOI$246,212$212,126$265,102$131,587$278,410$219,304$374,089$185,032$1,163,813$748,049
Outpatient Medical:
Total revenues$211,016$198,310$211,811$197,237$215,172$204,995$143,933$201,571$781,932$802,113
Property operating expenses64,60662,46362,83461,18563,31962,77842,47459,210233,233245,636
Consolidated NOI$146,410$135,847$148,977$136,052$151,853$142,217$101,459$142,361$548,699$556,477
Non-segment/Corporate:
Total revenues$89,170$76,751$86,947$90,192$113,768$107,997$80,080$89,833$369,965$364,773
Property operating expenses4,2824,2864,9484,7116,2874,6916,4826,38521,99920,073
Consolidated NOI$84,888$72,465$81,999$85,481$107,481$103,306$73,598$83,448$347,966$344,700

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a reconciliation of the properties included in our QTD Pool and YTD Pool for SSNOI:

QTD PoolYTD Pool
SSNOI Property Reconciliations:Seniors Housing OperatingTriple-netOutpatient MedicalTotalSeniors Housing OperatingTriple-netOutpatient MedicalTotal
Consolidated properties1,7868111292,7261,7868111292,726
Unconsolidated properties1017317410173174
Total properties1,8878112022,9001,8878112022,900
Recent acquisitions and development conversions(1)(586)(312)(8)(906)(823)(359)(10)(1,192)
Under development(43)(43)(43)(43)
Under redevelopment(2)(2)(1)(3)(2)(1)(3)
Current held for sale(13)(3)(82)(98)(13)(3)(82)(98)
Land parcels, loans and leased properties(174)(34)(8)(216)(174)(34)(8)(216)
Transitions(3)(185)(28)(213)(185)(28)(213)
Other(4)(9)(2)(11)(9)(2)(11)
Same store properties8754311041,4106383841021,124
(1) Acquisitions and development conversions will enter the QTD Pool after five full quarters and the YTD Pool after eight full quarters from acquisition or certificate of occupancy.
(2) Redevelopment properties will enter the QTD Pool after five full quarters and the YTD Pool after eight full quarters of operations post redevelopment completion.
(3) Transitioned properties will enter the QTD Pool after five full quarters and the YTD Pool after eight full quarters of operations with the new operator in place or under the new structure.
(4) Represents properties that are either closed or being closed.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a reconciliation of our consolidated NOI to same store NOI for the periods presented for the respective pools (in thousands):

QTD PoolYTD Pool
Three Months EndedTwelve Months Ended
SSNOI Reconciliations:December 31, 2025December 31, 2024December 31, 2025December 31, 2024
Seniors Housing Operating:
Consolidated NOI$697,933$430,689$2,289,475$1,511,681
NOI attributable to unconsolidated investments20,09223,28280,56890,812
NOI attributable to noncontrolling interests(13,355)(12,369)(52,056)(52,437)
NOI attributable to non-same store properties(229,879)(51,765)(816,410)(315,376)
Non-cash NOI attributable to same store properties(2,010)(1,963)(8,087)(9,233)
Currency and ownership adjustments (1)(4,939)(594)(9,597)524
SSNOI at Welltower Share467,842387,2801,483,8931,225,971
Triple-net:
Consolidated NOI374,089185,0321,163,813748,049
NOI attributable to unconsolidated investments3,504
NOI attributable to noncontrolling interests(1,685)(5,314)(11,638)(29,387)
NOI attributable to non-same store properties(201,500)(13,655)(568,349)(161,081)
Non-cash NOI attributable to same store properties(18,722)(20,793)(62,473)(63,883)
Currency and ownership adjustments (1)(1,580)1,671(404)9,347
SSNOI at Welltower Share150,602146,941520,949506,549
Outpatient Medical:
Consolidated NOI101,459142,361548,699556,477
NOI attributable to unconsolidated investments4,2494,09916,68117,244
NOI attributable to noncontrolling interests(1,846)(2,491)(9,721)(9,898)
NOI attributable to non-same store properties(77,845)(118,040)(465,620)(472,367)
Non-cash NOI attributable to same store properties(2,239)(2,706)(6,743)(10,145)
Currency and ownership adjustments (1)2(66)
SSNOI at Welltower Share23,77823,22383,29881,245
SSNOI at Welltower Share:
Seniors Housing Operating467,842387,2801,483,8931,225,971
Triple-net150,602146,941520,949506,549
Outpatient Medical23,77823,22383,29881,245
Total$642,222$557,444$2,088,140$1,813,765
(1) Includes adjustments to reflect consistent property ownership percentages, to translate Canadian properties at a USD/CAD rate of 1.43 and to translate U.K. properties at a GBP/USD rate of 1.23.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The table below reflects the reconciliation of EBITDA and Adjusted EBITDA to net income, the most directly comparable U.S. GAAP measure, for the periods presented. Dollars are in thousands.

Year Ended December 31,
Adjusted EBITDA Reconciliation:202520242023
Net income (loss)$961,837$972,857$358,139
Interest expense651,955574,261607,846
Income tax expense (benefit)(7,116)2,7006,364
Depreciation and amortization2,084,8681,632,0931,401,101
EBITDA3,691,5443,181,9112,373,450
Loss (income) from unconsolidated entities14,29749653,442
Stock-based compensation expense1,555,85874,48236,611
Loss (gain) on extinguishment of debt, net9,2452,1307
Loss (gain) on real estate dispositions and acquisitions of controlling interests, net(1,449,043)(451,611)(67,898)
Impairment of assets121,28392,79336,097
Provision for loan losses, net(9,416)10,1259,809
Loss (gain) on derivatives and financial instruments, net22,407(27,887)(2,120)
Other expenses201,201117,459108,341
Lease termination and leasehold interest adjustment (1)(65,485)
Casualty losses, net of recoveries11,36712,26110,107
Other impairment, net (2)604139,65216,642
Adjusted EBITDA$4,169,347$3,151,811$2,509,003
Adjusted Interest Coverage Ratio:
Interest expense$651,955$574,261$607,846
Capitalized interest33,79958,11550,699
Non-cash interest expense(51,629)(42,388)(23,494)
Total interest634,125589,988635,051
EBITDA$3,691,544$3,181,911$2,373,450
Interest coverage ratio5.82x5.39x3.74x
Adjusted EBITDA$4,169,347$3,151,811$2,509,003
Adjusted interest coverage ratio6.57x5.34x3.95x
Adjusted Fixed Charge Coverage Ratio:
Total interest$634,125$589,988$635,051
Secured financing principal amortization64,40847,32954,076
Total fixed charges698,533637,317689,127
EBITDA$3,691,544$3,181,911$2,373,450
Fixed charge coverage ratio5.28x4.99x3.44x
Adjusted EBITDA$4,169,347$3,151,811$2,509,003
Adjusted fixed charge coverage ratio5.97x4.95x3.64x

(1) Primarily relates to the derecognition of leasehold interests and the gain recognized in other income.

(2) Represents the write-off of straight-line rent receivable and unamortized lease incentive balances relating to leases placed on cash recognition.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Our leverage ratios include book capitalization, undepreciated book capitalization and enterprise value. Book capitalization represents the sum of net debt (defined as total long-term debt excluding operating lease liabilities, less cash and cash equivalents and restricted cash), total equity and redeemable noncontrolling interests. Undepreciated book capitalization represents book capitalization adjusted for accumulated depreciation and amortization. Enterprise value represents book capitalization adjusted for the fair market value of our common stock. Our leverage ratios are defined as the proportion of net debt to total capitalization. The table below reflects the reconciliation of our leverage ratios to our balance sheets for the periods presented. Amounts are in thousands, except share price.

Year Ended December 31,
202520242023
Book capitalization:
Unsecured credit facility and commercial paper$$$
Long-term debt obligations(1)19,737,44615,608,29415,815,226
Cash and cash equivalents and restricted cash(5,209,539)(3,711,457)(2,076,083)
Total net debt14,527,90711,896,83713,739,143
Total equity and noncontrolling interests(2)43,202,93932,572,58626,371,727
Book capitalization$57,730,846$44,469,423$40,110,870
Net debt to book capitalization ratio25.2%26.8%34.3%
Undepreciated book capitalization:
Total net debt$14,527,907$11,896,837$13,739,143
Accumulated depreciation and amortization10,350,62110,626,2639,274,814
Total equity and noncontrolling interests(2)43,202,93932,572,58626,371,727
Undepreciated book capitalization$68,081,467$55,095,686$49,385,684
Net debt to undepreciated book capitalization ratio21.3%21.6%27.8%
Enterprise value:
Common shares outstanding696,507635,289564,241
Period end share price$185.61$126.03$90.17
Common equity market capitalization$129,278,664$80,065,473$50,877,611
Total net debt14,527,90711,896,83713,739,143
Noncontrolling interests(2)1,073,441616,378967,351
Consolidated enterprise value$144,880,012$92,578,688$65,584,105
Net debt to consolidated enterprise value ratio10.0%12.9%20.9%

(1) Amounts include senior unsecured notes, secured debt and lease liabilities related to finance leases, as reflected on our Consolidated Balance Sheets. Operating lease liabilities related to ASC 842 are excluded.

(2) Includes amounts attributable to both redeemable noncontrolling interests and noncontrolling interests as reflected on our Consolidated Balance Sheets.

Critical Accounting Policies and Estimates

Our consolidated financial statements are prepared in accordance with U.S. GAAP, which requires us to make estimates and assumptions. Management considers an accounting estimate or assumption critical if:

•the nature of the estimates or assumptions is material due to the levels of subjectivity and judgment necessary to account for highly uncertain matters or the susceptibility of such matters to change; and

•the impact of the estimates and assumptions on financial condition or operating performance is material.

Management has discussed the development and selection of its critical accounting policies and estimates with the Audit Committee of the Board of Directors. Management believes the current assumptions and other considerations used to estimate amounts reflected in our consolidated financial statements are appropriate and are not reasonably likely to change in the future. However, since these estimates require assumptions to be made that were uncertain at the time the estimate was made, they bear the risk of change. If actual experience differs from the assumptions and other considerations used in estimating amounts reflected in our consolidated financial statements, the resulting changes could have a material adverse effect on our consolidated results of operations, liquidity and/or financial condition. Please refer to Note 2 to our consolidated financial statements for further information on significant accounting policies that impact us and for the impact of new accounting standards, including accounting pronouncements that were issued but not yet adopted by us.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following table presents information about our critical accounting policies and estimates:

Nature of Critical Accounting EstimateAssumptions/Approach Used
Impairment of Real Property Owned and Investments in Unconsolidated EntitiesAssessing impairment of real property owned and investments in unconsolidated entities involves subjectivity in determining if indicators of impairment are present and in estimating the future undiscounted cash flows or estimated fair value of an asset. The evaluation of indicators of impairment is dependent on a number of factors, including when there is an unfavorable change in the operating performance of the property, a change in management’s intent to hold and operate the property or a change in the property’s use. If an indicator of impairment of the property is identified, management estimates whether the carrying value is recoverable using observable and unobservable inputs such as historical and forecasted cash flows and estimated capitalization rates, all of which are affected by our expectations of future market or economic conditions. These inputs can have a significant impact on the undiscounted cash flows. The evaluation of indicators of impairment of investments in unconsolidated entities is dependent on a number of factors including the performance of each investment, a change in market conditions or a change in management’s investment strategy. When required, we estimate the fair value of an investment and, if such fair value is lower than carrying value, assess whether any impairment is other-than-temporary using observable and unobservable inputs such as historical and forecasted cash flows and estimated capitalization rates. These inputs can have a significant impact on the calculation of the fair value of the investment.Quarterly, we review our real property owned on a property by property basis to determine if facts and circumstances suggest the property may be impaired. These indicators may include expected operational performance, the tenant’s ability to make rent payments, a change in management’s intent to hold and operate the property and changes in the market that may permanently reduce the value of the property. If indicators of impairment exist, an undiscounted cash flow analysis will be prepared to determine if the value of the property will be recoverable. If the estimated undiscounted cash flows indicate that the carrying value of the property will not be recoverable, the carrying value of the property is reduced to its estimated fair value and an impairment charge is recognized for the difference between the carrying value and the fair value. The analysis requires us to use judgment in determining whether indicators of impairment exist and to estimate the expected future undiscounted cash flows or estimated fair values of the property. Properties that meet the held for sale criteria are recorded at the lesser of the fair value less costs to sell or carrying value.We also evaluate investments in unconsolidated entities for indicators of impairment and, when present, record impairment charges based on a comparison of the estimated fair value of the equity method investment to its carrying value if the decline in the estimated fair value of such an investment below its carrying value is other-than-temporary. At December 31, 2025, our net real property owned was approximately $53,423,291,000 and investments in unconsolidated entities totaled $1,809,590,000. During the year ended December 31, 2025, we recorded impairment charges of $121,283,000 related to 10 Seniors Housing Operating properties, eight Triple-net properties and four Outpatient Medical properties. No impairment losses related to investments in unconsolidated entities were recorded during the year ended December 31, 2025.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Nature of Critical Accounting EstimateAssumptions/Approach Used
Real Estate AcquisitionsMost of our real estate acquisitions are considered asset acquisitions for which we record the related real estate acquired (tangible assets and identifiable intangible assets and liabilities) at cost on a relative fair value basis. Liabilities assumed and any associated noncontrolling interests are reflected at fair value. Tangible assets consist primarily of land, building and improvements. Identifiable intangible assets and liabilities primarily consist of the above or below market component of in-place leases and the value of in-place leases. The total amount of other intangible assets acquired is further allocated to in-place lease values and customer relationship values based on management’s evaluation of the specific characteristics of each tenant’s lease and our overall relationship with respect to that tenant. For real estate acquisitions accounted for as business combinations, we allocate the acquisition consideration to the assets acquired, liabilities assumed and noncontrolling interests at fair value as of the acquisition date. Any excess of the consideration transferred relative to the fair value of the net assets acquired is accounted for as goodwill.In determining the fair values that drive the recorded tangible assets and identifiable intangible assets and liabilities, we estimate the fair value of each component of the real estate acquired, which generally includes land, buildings and improvements, the above or below market component of in-place leases and the value of in-place leases using a number of sources including independent appraisals, our own analysis of recently acquired or developed and existing comparable properties in our portfolio and other market data. Significant assumptions used to determine such fair values include comparable land sales, capitalization rates, discount rates, market rental rates and property operating data, all of which can be impacted by expectations about future market or economic conditions. Our estimates of the values of these components affect the amount of depreciation and amortization we record over the estimated useful life of the property or the term of the lease and the amount of goodwill recognized in an acquisition accounted for as a business combination.During the year ended December 31, 2025, we disbursed $13,913,975,000 of net cash related to real estate asset acquisitions and business combinations.
Principles of ConsolidationThe consolidated financial statements include our accounts, the accounts of our wholly-owned subsidiaries and the accounts of joint venture entities in which we own a majority voting interest with the ability to control operations and where no substantive participating rights or substantive kick out rights have been granted to the noncontrolling interests. In addition, we consolidate those entities deemed to be variable interest entities (“VIEs”) in which we are determined to be the primary beneficiary. All material intercompany transactions and balances have been eliminated in consolidation.We make judgments about which entities are VIEs based on an assessment of whether (i) the equity investors as a group, if any, do not have a controlling financial interest or (ii) the equity investment at risk is insufficient to finance that entity’s activities without additional subordinated financial support. We make judgments with respect to our level of influence or control of an entity and whether we are (or are not) the primary beneficiary of a VIE. Consideration of various factors include, but is not limited to, our ability to direct the activities that most significantly impact the entity’s economic performance, our form of ownership interest, our representation on the entity’s governing body, the size and seniority of our investment, our ability and the rights of other investors to participate in policy making decisions, replace the manager and/or liquidate the entity, if applicable. Our ability to correctly assess our influence or control over an entity at inception of our involvement or on a continuous basis when determining the primary beneficiary of a VIE affects the presentation of these entities in our consolidated financial statements. If we perform a primary beneficiary analysis at a date other than at inception of the VIE, our assumptions may be different and may result in the identification of a different primary beneficiary.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Nature of Critical Accounting EstimateAssumptions/Approach Used
Stock Based CompensationThe recognition of stock based compensation expense for equity awards including stock options, restricted stock units and performance-based awards is based on the grant date fair value of the awards and is recognized over the requisite service period. Stock-based compensation requires management to make significant judgments and estimates used in (i) determining the fair value of awards at grant date and (ii) estimating the amount of expense to recognize over the service period.Certain of the Executive & Key Employee LTIP Unit Awards have market conditions that determine the number of LTIP units earned by the executive officers and key employees at the end of the measurement period. The Executive & Key Employee LTIP Unit Awards also have certain service conditions that affect the timing of the employees’ ability to redeem the LTIP units for common shares. We estimated the fair value of the Executive & Key Employee LTIP Unit Awards using a Monte Carlo valuation model, which incorporates various inputs and assumptions, including the risk-free rate, the grant date common share price, expected dividend yield and common share price volatility, as well as the expected volatility of comparative indices used in the measurement of award achievement. We recognized $1,556,732,000 in stock-based compensation expense during the year ended December 31, 2025, of which $1,408,672,000 was related to the Executive & Key Employee LTIP Unit Awards.
Allowance for Credit Losses on Loans ReceivableThe allowance for credit losses is maintained at a level believed adequate to absorb potential losses in our loans receivable. The determination of the credit allowance is based on a quarterly evaluation of all outstanding loans, including general economic conditions and estimated collectability of loan payments.We evaluate the collectability of our loans receivable based on a combination of factors, including, but not limited to, payment status, historical loan charge-offs, financial strength of the borrower and guarantors, and nature, extent and value of the underlying collateral. A loan is considered to have deteriorated credit quality when, based on current information and events, it is probable that we will be unable to collect all amounts due as scheduled according to the contractual terms of the loan agreement. For those loans we identified as having deteriorated credit quality, we determine the amount of credit loss on an individual basis. Placement on non-accrual status may be required. Consistent with this definition, all loans on non-accrual are deemed to have deteriorated credit quality. To the extent circumstances improve and the risk of collectability is diminished, we may return these loans to income accrual status. While a loan is on non-accrual status, any cash receipts are applied against the outstanding principal balance. For the remaining loans, we assess credit loss on a collective pool basis and use our historical loss experience for similar loans to determine the reserve for credit losses.During the year ended December 31, 2025, we recognized provision for loan losses of $(9,416,000), which includes changes in the reserve based on our historical loss experience.

MD&A history

Prior-year 10-K MD&A spans are extracted from SEC filings with the same bounded parser used for the latest filing. The latest 10-K appears above; prior years are below.

FY 2024 10-K MD&A

SEC filing source: 0000766704-25-000009.

Extracted structurally from real Item 7 body heading to real Item 7A/8 boundary. Confidence: high. Filing date: 2025-02-12. Report date: 2024-12-31.

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

EXECUTIVE SUMMARY
Company Overview52
Business Strategy52
Key Transactions53
Key Performance Indicators, Trends and Uncertainties54
Corporate Governance56
LIQUIDITY AND CAPITAL RESOURCES
Sources and Uses of Cash56
Off-Balance Sheet Arrangements57
Contractual Obligations58
Capital Structure58
Supplemental Guarantor Information59
RESULTS OF OPERATIONS
Summary59
Seniors Housing Operating61
Triple-net63
Outpatient Medical65
Non-Segment/Corporate66
OTHER
Non-GAAP Financial Measures67
Critical Accounting Policies and Estimates74

51

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following discussion and analysis is based primarily on the consolidated financial statements of Welltower Inc. presented in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for the periods presented and should be read together with the notes thereto contained in this Annual Report on Form 10-K. Other important factors are identified in “Item 1 — Business” and “Item 1A — Risk Factors” above.

We are organized in an UPREIT structure. In February 2022, the company formerly known as Welltower Inc. ("Old Welltower") formed WELL Merger Holdco Inc. ("New Welltower") as a wholly owned subsidiary, and New Welltower formed WELL Merger Holdco Sub Inc. ("Merger Sub") as a wholly owned subsidiary. On April 1, 2022, Merger Sub merged with and into Old Welltower, with Old Welltower continuing as the surviving corporation and a wholly owned subsidiary of New Welltower (the "Merger"). In connection with the Merger, Old Welltower's name was changed to "Welltower OP Inc.", and New Welltower inherited the name "Welltower Inc." Effective May 24, 2022, Welltower OP Inc. converted from a Delaware corporation into Welltower OP, a Delaware limited liability company (the "LLC Conversion"). Following the LLC Conversion, New Welltower's business continues to be conducted through Welltower OP and New Welltower does not have substantial assets or liabilities, other than through its investment in Welltower OP.

Unless stated otherwise or the context otherwise requires, references to "Welltower" mean Welltower Inc. and references to "Welltower OP" mean Welltower OP LLC. References to "we," "us" and "our" mean collectively Welltower, Welltower OP and those entities/subsidiaries owned or controlled by Welltower and/or Welltower OP.

Executive Summary

Company Overview

Welltower Inc. (NYSE:WELL), a real estate investment trust ("REIT") and S&P 500 company headquartered in Toledo, Ohio, is driving the transformation of healthcare infrastructure. Welltower invests with leading seniors housing operators, post-acute providers and health systems to fund the real estate and infrastructure needed to scale innovative care delivery models and improve people’s wellness and overall healthcare experience. Welltower owns interests in properties concentrated in major, high-growth markets in the United States ("U.S."), Canada and the United Kingdom ("U.K."), consisting of seniors housing and post-acute communities and outpatient medical properties.

Welltower is the initial member and majority owner of Welltower OP, with an approximate ownership interest of 99.707% as of December 31, 2024. All of our property ownership, development and related business operations are conducted through Welltower OP and Welltower has no material assets or liabilities other than its investment in Welltower OP. Welltower issues equity from time to time, the net proceeds of which it is obligated to contribute as additional capital to Welltower OP. All debt including credit facilities, senior notes and secured debt is incurred by Welltower OP and its subsidiaries, and Welltower has fully and unconditionally guaranteed all existing senior unsecured notes.

The following table summarizes our consolidated portfolio for the year ended December 31, 2024 (dollars in thousands):

Percentage ofNumber of
Type of PropertyNOI(1)NOIProperties
Seniors Housing Operating$1,511,68153.7%1,156
Triple-net748,04926.6%592
Outpatient Medical556,47719.7%371
Totals$2,816,207100.0%2,119

(1) Represents consolidated net operating income ("NOI") and excludes our share of investments in unconsolidated entities. Entities in which we have a joint venture with a minority partner are shown at 100% of the joint venture amount. Non-segment/Corporate NOI, which includes the loan portfolio, is excluded. See Non-GAAP Financial Measures for additional information and reconciliation.

Business Strategy

Our primary objectives are to protect stockholder capital and enhance stockholder value. We seek to pay consistent cash dividends to stockholders and create opportunities to increase dividend payments to stockholders through annual increases in NOI and portfolio growth. To meet these objectives, we invest across the full spectrum of seniors housing and healthcare real estate and diversify our investment portfolio by property type, relationship and geographic location.

Substantially all of our revenues are derived from operating lease rentals, resident fees and services, interest earned on outstanding loans receivable and interest earned on short-term deposits. These items represent our primary sources of liquidity to fund distributions and depend upon the continued ability of our obligors to make contractual rent and interest payments to us and the profitability of our operating properties. To the extent that our obligors/partners experience operating difficulties and become unable to generate sufficient cash to make payments or operating distributions to us, there could be a material adverse impact on our consolidated results of operations, liquidity and/or financial condition.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

To mitigate this risk, we monitor our investments through a variety of methods determined by the type of property. Our asset management process for seniors housing properties generally includes review of monthly financial statements and other operating data for each property, review of obligor/partner creditworthiness, property inspections and review of covenant compliance relating to licensure, real estate taxes, letters of credit and other collateral. Our internal property management division manages and monitors the outpatient medical portfolio with a comprehensive process, including review of tenant relations, lease expirations, the mix of health service providers, hospital/health system relationships, property performance, capital improvement needs and market conditions, among other things. We evaluate the operating environment in each property’s market to determine the likely trend in operating performance of the facility. When we identify unacceptable trends, we seek to mitigate, eliminate or transfer the risk. Through these efforts, we generally aim to intervene at an early stage to address any negative trends, and in so doing, support both the collectability of revenue and the value of our investment.

In addition to our asset management and research efforts, we aim to structure our relevant investments to mitigate payment risk. Operating leases and loans are normally credit enhanced by guarantees and/or letters of credit. Also, operating leases are typically structured as master leases and loans are generally cross-defaulted and cross-collateralized with other real estate loans, operating leases or agreements between us and the obligor and its affiliates.

For the year ended December 31, 2024, resident fees and services and rental income represented 75% and 20% of total revenues, respectively. Substantially all of our operating leases are designed with escalating rent structures. Leases with fixed annual rental escalators are generally recognized on a straight-line basis over the initial lease period, subject to a collectability assessment. Rental income related to leases with contingent rental escalators is generally recorded based on the contractual cash rental payments due for the period. Our yield on loans receivable depends upon a number of factors, including the stated interest rate, the average principal amount outstanding during the term of the loan and any interest rate adjustments.

Our primary sources of cash include resident fees and services revenue, rental income and interest receipts, interest earned on short-term deposits, borrowings under our unsecured revolving credit facility and commercial paper program, issuances of debt and equity securities including through our ATM Program (as defined below), proceeds from investment dispositions and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including acquisitions, capital expenditures, construction advances and transaction costs), loan advances, property operating expenses, general and administrative expenses and other expenses. Depending upon the availability and cost of external capital, we believe our liquidity is sufficient to fund these uses of cash.

We also continuously evaluate opportunities to finance future investments. New investments are generally funded from temporary borrowings under our unsecured revolving credit facility and commercial paper program, internally generated cash and the proceeds from investment dispositions. Our investments generate cash from NOI and principal payments on loans receivable. Permanent financing for future investments, which replaces funds drawn under our unsecured revolving credit facility and commercial paper program, has historically been provided through a combination of the issuance of debt and equity securities and the incurrence or assumption of secured debt. Given the general economic conditions during 2023 and 2024, investments were generally funded proactively via issuances of common stock.

Depending upon market conditions, we believe that new investments will be available in the future with spreads over our cost of capital that will generate appropriate returns to our stockholders. It is also likely that investment dispositions may occur in the future. To the extent that investment dispositions exceed new investments, our revenues and cash flows from operations could be adversely affected. We expect to reinvest the proceeds from any investment dispositions in new investments. To the extent that new investment requirements exceed our available cash on-hand, we expect to borrow under our unsecured revolving credit facility and commercial paper program or issue debt or equity securities, including through our ATM Program. At December 31, 2024, we had $3,506,586,000 of cash and cash equivalents, $204,871,000 of restricted cash and $5,000,000,000 of available borrowing capacity under our unsecured revolving credit facility.

Key Transactions

Capital  The following summarizes key capital transactions that occurred during the year ended December 31, 2024:

•In October 2024, we entered into an equity distribution agreement whereby we may offer and sell up to $5,000,000,000 of common stock, which replaced our prior equity distribution agreement dated April, 2024, allowing us to sell up to $3,500,000,000 aggregate amount of our common stock (collectively, along with other previous agreements, referred to as the "ATM Programs"). During the year ended December 31, 2024, we sold 70,419,530 shares of common stock under our current and previous ATM Programs generating gross proceeds of approximately $7,452,108,000.

•In January 2024, we repaid our $400,000,000 4.5% senior unsecured notes at maturity. In March 2024, we repaid our $950,000,000 3.625% senior unsecured notes at maturity.

•In July 2024, we closed on an expanded $5,000,000,000 unsecured revolving credit facility, which replaced our $4,000,000,000 existing line of credit. The new facility is comprised of a $3,000,000,000 revolving line of credit maturing in June 2028 that can be extended for an additional year and a $2,000,000,000 revolving line of credit maturing in June 2029. The revolving lines of credit will bear interest at a borrowing rate of 0.725% over the adjusted SOFR rate and include an annual facility fee of 0.125%.

53

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

•In July 2024, Welltower OP issued $1,035,000,000 aggregate principal amount of 3.125% exchangeable senior unsecured notes maturing July 15, 2029 (the "2029 Exchangeable Notes") unless earlier exchanged, purchased or redeemed. The 2029 Exchangeable Notes will pay interest semi-annually in arrears on January 15 and July 15 of each year.

•In August 2024, we increased the size of the commercial paper program to $2,000,000,000.

•During the year ended December 31, 2024, we extinguished $450,720,000 of secured debt at a blended average interest rate of 6.13% and disposed $359,140,000 of secured debt at a blended average interest rate of 4.79%.

•During the year ended December 31, 2024, we issued $197,930,000 of secured debt at a blended average interest rate of 4.27% and assumed $960,300,000 of secured debt at a blended average interest rate of 3.98%.

Investments The following summarizes our property acquisitions and joint venture investments completed during the year ended December 31, 2024 (dollars in thousands):

PropertiesBook Amount(1)Capitalization Rates(2)
Seniors Housing Operating198$4,542,7527.2%
Triple-net521,126,4928.4%
Outpatient Medical146,8547.7%
Totals251$5,716,0987.5%

(1) Represents amounts recorded in net real estate investments including fair value adjustments pursuant to U.S. GAAP. See Note 3 to our consolidated financial statements for additional information.

(2) Represents annualized contractual or projected NOI to be received in cash divided by investment amounts.

Dispositions The following summarizes property dispositions completed during the year ended December 31, 2024 (dollars in thousands):

PropertiesProceeds(1)Book Amount(2)Capitalization Rates(3)
Seniors Housing Operating(4)31$525,462$390,2264.3%
Triple-net(5)21195,572355,5807.3%
Outpatient Medical(4)349,81742,7616.8%
Totals55$770,851$788,5675.7%

(1) Represents net proceeds received upon disposition, excluding non-cash consideration.

(2) Represents carrying value of net real estate assets at time of disposition. See Note 5 to our consolidated financial statements for additional information.

(3) Represents annualized contractual income that was being received in cash at date of disposition divided by stated purchase price.

(4) Includes the disposition of unconsolidated equity method investments that owned six Seniors Housing Operating properties and one Outpatient Medical property.

(5) Excludes $79,695,000 of net real property derecognized related to four properties upon the reclassification of one lease from operating to sales-type and includes $297,000,000 of net real property derecognized in the third quarter related to 11 properties upon reclassification of one lease from operating to sales-type for which the underlying properties were sold and the sales-type lease terminated in the fourth quarter.

During 2023, we entered into definitive agreements to dissolve our existing Revera joint venture relationships across the U.S., U.K. and Canada. The transactions included acquiring the remaining interests in 110 properties from Revera while simultaneously selling interest in 31 properties to Revera. See Note 5 to our consolidated financial statements for further information regarding the transactions.

During 2024, Welltower, which held a 25% minority interest in an existing equity method joint venture that owned 39 properties subject to triple-net leases with two tenants, acquired the remaining beneficial interest. See Note 3 to our consolidated financial statements for further information regarding the transaction.

Dividends Our Board of Directors declared a cash dividend for the quarter ended December 31, 2024 of $0.67 per share. On March 6, 2025, we will pay our 215th consecutive quarterly cash dividend to stockholders of record on February 25, 2025.

Key Performance Indicators, Trends and Uncertainties

We utilize several key performance indicators to evaluate the various aspects of our business. These indicators are discussed below and relate to operating performance, credit strength and concentration risk. Management uses these key performance indicators to facilitate internal and external comparisons to our historical operating results, in making operating decisions and for budget planning purposes.

Operating Performance We believe that net income and net income attributable to common stockholders ("NICS") as reflected in the Consolidated Statements of Comprehensive Income are the most appropriate earnings measures. Other useful supplemental measures of our operating performance include funds from operations attributable to common stockholders ("FFO") and consolidated net operating income ("NOI"); however, these supplemental measures are not defined by U.S.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

GAAP. Please refer to the section entitled "Non-GAAP Financial Measures" for further discussion and reconciliations. These earnings measures are widely used by investors and analysts in the valuation, comparison and investment recommendations of companies.

The following table reflects the recent historical trends of our operating performance measures for the periods presented (in thousands):

Year Ended December 31,
202420232022
Net income$972,857$358,139$160,568
Net income attributable to common stockholders951,680340,094141,214
Funds from operations attributable to common stockholders2,323,4331,763,2271,478,072
Consolidated net operating income3,160,9072,690,2192,301,845

Credit Strength We measure our credit strength both in terms of leverage ratios and coverage ratios. The leverage ratios indicate how much of our balance sheet capitalization is related to long-term debt, net of cash and restricted cash. The coverage ratios indicate our ability to service interest and fixed charges (interest and secured debt principal amortization). We expect to maintain capitalization ratios and coverage ratios sufficient to maintain a capital structure consistent with our current profile. The coverage ratios are based on earnings before interest, taxes, depreciation and amortization ("EBITDA") and adjusted earnings before interest, taxes, depreciation and amortization ("Adjusted EBITDA"). Please refer to the section entitled "Non-GAAP Financial Measures" for further discussion and reconciliation of these measures. Leverage ratios and coverage ratios are widely used by investors, analysts and rating agencies in the valuation, comparison, investment recommendations and rating of companies. The following table reflects the recent historical trends for our credit strength measures for the periods presented:

Year Ended December 31,
202420232022
Net debt to book capitalization ratio26.8%34.3%39.5%
Net debt to undepreciated book capitalization ratio21.6%27.8%32.1%
Net debt to enterprise ratio12.9%20.9%29.5%
Interest coverage ratio5.39x3.74x3.73x
Fixed charge coverage ratio4.99x3.44x3.37x
Adjusted interest coverage ratio5.34x3.95x3.94x
Adjusted fixed charge coverage ratio4.95x3.64x3.56x

Concentration Risk We evaluate our concentration risk in terms of NOI by property mix, relationship mix and geographic mix. Concentration risk is a valuable measure in understanding what portion of our NOI could be at risk if certain sectors were to experience downturns. Property mix measures the portion of our NOI that relates to our various property types and excludes interest income earned on our loan portfolio, which is classified as Non-segment/Corporate. Relationship mix measures the portion of our NOI that relates to our current top five relationships. Geographic mix measures the portion of our NOI that relates to our current top five states (or countries outside the U.S.).

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following table reflects our recent historical trends of concentration risk by NOI for the years indicated below:

Year Ended December 31,(1)
202420232022
Property mix:
Seniors Housing Operating54%45%45%
Triple-net27%34%34%
Outpatient Medical19%21%21%
Relationship mix:
Cogir Management Corporation7%4%3%
Integra Healthcare Properties7%8%—%
Sunrise Senior Living5%6%7%
Avery Healthcare4%4%3%
Oakmont Management Group4%4%2%
Remaining73%74%85%
Geographic mix:
California11%12%14%
United Kingdom11%9%10%
Florida8%6%6%
Texas8%8%8%
Canada6%6%6%
Remaining56%59%56%

(1) Excludes our share of investments in unconsolidated entities. Entities in which we have a joint venture with a minority partner are shown at 100% of the joint venture amount.

We evaluate our key performance indicators in conjunction with current expectations to determine if historical trends are indicative of future results. Our expected results may not be achieved, and actual results may differ materially from our expectations. Factors that may cause actual results to differ from expected results are described in more detail in "Item 1 — Business — Cautionary Statement Regarding Forward-Looking Statements" and "Item 1A — Risk Factors" and other sections of this Annual Report on Form 10-K. Management regularly monitors economic and other factors to develop strategic and tactical plans designed to improve performance and maximize our competitive position. Our ability to achieve our financial objectives is dependent upon our ability to effectively execute these plans and to appropriately respond to emerging economic and company-specific trends. Please refer to "Item 1 — Business," "Item 1A — Risk Factors" in this Annual Report on Form 10-K for further discussion of these risk factors.

Corporate Governance

Maintaining investor confidence and trust is important in today's business environment. Our Board of Directors and management are strongly committed to policies and procedures that reflect the highest level of ethical business practices. Our corporate governance guidelines provide the framework for our business operations and emphasize our commitment to increase stockholder value while meeting all applicable legal requirements. These guidelines meet the listing standards adopted by the New York Stock Exchange and are available on the Internet at www.welltower.com/investors/governance. The information on our website is not incorporated by reference in this Annual Report on Form 10-K, and our web address is included as an inactive textual reference only.

Liquidity and Capital Resources

Sources and Uses of Cash

Our primary sources of cash include resident fees and services, rent and interest receipts, interest earned on short-term deposits, borrowings under our unsecured revolving credit facility and commercial paper program, issuances of debt and equity securities, proceeds from investment dispositions and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including acquisitions, capital expenditures, construction advances and transaction costs), loan advances, property operating expenses, general and administrative expenses and other expenses. Depending upon the availability and cost of external capital, we believe our liquidity is sufficient to fund these uses of cash. These sources and uses of cash are reflected in our Consolidated Statements of Cash Flows and are discussed in further detail below. The following is a summary of our sources and uses of cash flows for the periods presented (dollars in thousands):

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
Cash, cash equivalents and restricted cash at beginning of period$2,076,083$722,292$1,353,791187%$346,755$375,537108%$1,729,328499%
Net cash provided from (used in):
Operating activities2,256,4211,601,861654,56041%1,328,708273,15321%927,71370%
Investing activities(5,514,681)(5,707,742)193,061-3%(3,703,815)(2,003,927)54%(1,810,866)49%
Financing activities4,905,3515,448,647(543,296)-10%2,761,2772,687,37097%2,144,07478%
Effect of foreign currency translation(11,717)11,025(22,742)n/a(10,633)21,658n/a(1,084)10%
Cash, cash equivalents and restricted cash at end of period$3,711,457$2,076,083$1,635,37479%$722,292$1,353,791187%$2,989,165414%

Operating Activities Please see "Results of Operations" for discussion of net income fluctuations. For the years ended December 31, 2024, 2023 and 2022, cash flows provided from operations exceeded cash distributions to stockholders.

Investing Activities  The changes in net cash provided from/used in investing activities are primarily attributable to net changes in real property investments and dispositions, loans receivable and investments in unconsolidated entities, which are summarized above in "Key Transactions." Please refer to Notes 3 and 5 of our consolidated financial statements for additional information. The following is a summary of cash used in non-acquisition capital improvement activities for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
New development$827,900$1,014,935$(187,035)-18%$631,737$383,19861%$196,16331%
Recurring capital expenditures, tenant improvements and lease commissions290,832199,35991,47346%198,576783%92,25646%
Renovations, redevelopments and other capital improvements566,714318,323248,39178%277,44040,88315%289,274104%
Total$1,685,446$1,532,617$152,82910%$1,107,753$424,86438%$577,69352%

The change in new development is primarily due to the number and size of construction projects ongoing during the relevant periods. Renovations, redevelopments and other capital improvements include expenditures to maximize property value, increase net operating income, maintain a market-competitive position and/or achieve property stabilization. The increase in renovations, redevelopments and other capital improvements is due primarily to portfolio growth.

Financing Activities The changes in net cash provided from/used in financing activities are primarily attributable to changes related to our long-term debt arrangements, the issuances of common stock and dividend payments. Financing activities occurring during the year ended December 31, 2024 are summarized above in “Key Transactions.” Please also refer to Notes 10, 11 and 14 to our consolidated financial statements for additional information.

In May 2023, we issued $1,035,000,000 aggregate principal amount of 2.75% exchangeable senior unsecured notes maturing May 15, 2028.

During the year ended December 31, 2023, we sold 53,300,874 shares of common stock under our ATM Programs generating gross proceeds of approximately $4,313,007,000.

In November 2023, we issued 20,125,000 shares of common stock generating gross proceeds of approximately $1,772,216,000.

Off-Balance Sheet Arrangements

At December 31, 2024, we had investments in unconsolidated entities with our ownership generally ranging from 10% to 95%. We use financial derivative instruments to hedge interest rate and foreign currency exchange rate exposure. At December 31, 2024, we had 20 outstanding letter of credit obligations. Please see Notes 8, 12 and 13 to our consolidated financial statements for additional information.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Contractual Obligations

The following table summarizes our payment requirements under contractual obligations as of December 31, 2024 (in thousands):

Payments Due by Period
Contractual ObligationsTotal20252026-20272028-2029Thereafter
Senior unsecured notes and term credit facilities:(1)
U.S. Dollar senior unsecured notes$10,620,000$1,250,000$1,200,000$3,870,000$4,300,000
Canadian Dollar senior unsecured notes(2)208,290208,290
Pounds Sterling senior unsecured notes(2)1,314,600688,600626,000
U.S. Dollar term credit facility1,010,00010,0001,000,000
Canadian Dollar term credit facility(2)173,575173,575
Secured debt:(1,2)
Consolidated2,467,223216,034484,970552,7311,213,488
Unconsolidated851,459590,357117,38666,00477,712
Contractual interest obligations:(3)
Senior unsecured notes and term loans(2)3,101,669480,204831,079552,1301,238,256
Consolidated secured debt(2)709,14897,243173,870130,332307,703
Unconsolidated secured debt(2)46,04521,01413,4737,1534,405
Financing lease liabilities(4)455,7547,88315,12510,653422,093
Operating lease liabilities(4)2,289,57179,616158,926158,1031,892,926
Purchase obligations(5)674,130538,937118,4521,41115,330
Total contractual obligations$23,921,464$3,291,288$4,495,146$6,037,117$10,097,913

(1) Amounts represent principal amounts due and do not reflect unamortized premiums/discounts or other fair value adjustments as reflected on the Consolidated Balance Sheets.

(2) Based on foreign currency exchange rates in effect as of the balance sheet date.

(3) Based on variable interest rates in effect as of December 31, 2024.

(4) See Note 6 to our consolidated financial statements for additional information.

(5) See Note 13 to our consolidated financial statements for additional information. Excludes amounts related to asset acquisitions under contract that have not yet closed as of December 31, 2024.

Capital Structure

Please refer to "Credit Strength" above for a discussion of our leverage and coverage ratio trends. Our debt agreements contain various covenants, restrictions and events of default. Certain agreements require us to maintain financial ratios and minimum net worth and impose certain limits on our ability to incur indebtedness, create liens and make investments or acquisitions. As of December 31, 2024, we were in compliance in all material respects with the covenants under our debt agreements. None of our debt agreements contain provisions for acceleration which could be triggered by our debt ratings. However, under our primary unsecured credit facility, the ratings on our senior unsecured notes are used to determine the fees and interest charged. We plan to manage the company to maintain compliance with our debt covenants and with a capital structure consistent with our current profile. Any downgrades in terms of ratings or outlook by any or all of the rating agencies could have a material adverse impact on our cost and availability of capital, which could have a material adverse impact on our consolidated results of operations, liquidity and/or financial condition.

On April 1, 2022, Welltower and Welltower OP jointly filed with the SEC an open-ended automatic or "universal" shelf registration statement on Form S-3 (the "Shelf Form S-3") covering an indeterminate amount of future offerings of Welltower's debt securities, common stock, preferred stock, depositary shares, guarantees of debt securities issued by Welltower OP, warrants and units and Welltower OP’s debt securities and guarantees of debt securities issued by Welltower. On April 1, 2022, Welltower also filed with the SEC a registration statement in connection with its enhanced dividend reinvestment plan ("DRIP") under which it may issue up to 15,000,000 shares of common stock. On May 3, 2023, Welltower and Welltower OP filed post-effective amendment no. 1 to the Shelf Form S-3 pursuant to which Welltower OP expressly adopted the Shelf Form S-3 as its own registration statement following its statutory conversion from a corporation to a limited liability company. As of February 7, 2025, 15,000,000 shares of common stock remained available for issuance under the DRIP registration statement. On October 29, 2024, Welltower and Welltower OP entered into an equity distribution agreement with (i) the sales agents and forward sellers named therein and (ii) the forward purchasers named therein relating to issuances, offers and sales from time to time of up to $5,000,000,000 aggregate amount of common stock of Welltower (together with the existing master forward sale confirmations relating thereto, the "ATM Program"). The ATM Program also allows Welltower to enter into forward sale agreements. As of February 7, 2025, we had $2,697,834,000 of remaining capacity under the ATM Program and there were no

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

outstanding forward sales agreements. Depending upon market conditions, we anticipate issuing securities under our registration statements to invest in additional properties and to repay borrowings under our unsecured revolving credit facility and commercial paper program.

In connection with the filing of the Shelf Form S-3, Welltower also filed with the SEC a prospectus supplement that will continue an offering that was previously covered by a prior registration statement relating to the registration of up to 475,327 shares of common stock of Welltower Inc. (the "DownREIT II Shares") that may be issued from time to time if, and to the extent that, certain holders of Class A units (the "DownREIT II Units") of HCN G&L DownREIT II LLC, a Delaware limited liability company (the "DownREIT II"), tender such DownREIT II Units for redemption by the DownREIT II, and HCN DownREIT Member, LLC, a majority-owned indirect subsidiary of Welltower (including its permitted successors and assigns, the "Managing Member"), or a designated affiliate of the Managing Member, elects to assume the redemption obligations of the DownREIT II and to satisfy all or a portion of the redemption consideration by issuing DownREIT II Shares to the holders instead of or in addition to paying a cash amount. On July 22, 2022, Welltower filed with the SEC a prospectus supplement relating to the registration of up to 300,026 shares of common stock of Welltower Inc. that may be issued from time to time if, and to the extent that, certain holders of Class A Common Units (the "OP Units") of Welltower OP tender the OP Units for redemption by Welltower OP, and Welltower Inc. elects to assume the redemption obligations of Welltower OP and to satisfy all or a portion of the redemption consideration by issuing shares of its common stock to the holders instead of or in addition to paying a cash amount. On October 8, 2024, Welltower filed with the SEC a prospectus supplement relating to the registration of up to 23,471,419 shares of common stock of Welltower Inc. (the "Exchanged Shares") that may, under certain circumstances, be issuable upon exchange of 2.750% exchangeable senior notes due 2028 or 3.125% exchangeable senior notes due 2029 of Welltower OP and the resale from time to time by the recipients of the Exchanged Shares.

Supplemental Guarantor Information

Welltower OP has issued the unsecured notes described in Note 11 to our Consolidated Financial Statements. All unsecured notes are fully and unconditionally guaranteed by Welltower, and Welltower OP is 99.707% owned by Welltower as of December 31, 2024. Effective January 4, 2021, the SEC adopted amendments to the financial disclosure requirements applicable to registered debt offerings that include certain credit enhancements. We have adopted these new rules, which permits subsidiary issuers of obligations guaranteed by the parent to omit separate financial statements if the consolidated financial statements of the parent company have been filed, the subsidiary obligor is a consolidated subsidiary of the parent company, the guaranteed security is debt or debt-like, and the security is guaranteed fully and unconditionally by the parent. Accordingly, separate consolidated financial statements of Welltower OP have not been presented. Furthermore, Welltower and Welltower OP have no material assets, liabilities or operations other than financing activities and their investments in non-guarantor subsidiaries. Therefore, we meet the criteria in Rule 13-01 of Regulation S-X to omit the summarized financial information from our disclosures.

Results of Operations

Summary

Our primary sources of revenue include resident fees and services revenue, rental income, interest income and interest earned on short-term deposits. Our primary expenses include property operating expenses, depreciation and amortization, interest expense, general and administrative expenses and other expenses. We evaluate our business and make resource allocations on our three operating segments: Seniors Housing Operating, Triple-net and Outpatient Medical. The primary performance measures for our properties are NOI and same store NOI ("SSNOI") and other supplemental measures include FFO and Adjusted EBITDA, which are further discussed below. Please see Non-GAAP Financial Measures for additional information and reconciliations related to these supplemental measures.

This section of this Form 10-K generally discusses 2024 and 2023 items and year-to-year comparisons between 2024 and 2023. Discussions of 2022 items and year-to-year comparisons between 2023 and 2022 that are not included in this Form 10-K can be found in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 of the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2023.

During the year ended December 31, 2024, we reclassified loans receivable balances, the related interest income and provision for loan losses from our three operating segments to Non-segment/Corporate to better align with the manner in which the CODM reviews results. Accordingly, the segment information provided in the Results of Operations section has been updated to conform to the current presentation for all periods presented.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a summary of our results of operations for the periods presented (dollars in thousands, except per share amounts):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023Amount%2022Amount%Amount%
Net income$972,857$358,139$614,718172%$160,568$197,571123%$812,289506%
NICS951,680340,094611,586180%141,214198,880141%810,466574%
FFO2,323,4331,763,227560,20632%1,478,072285,15519%845,36157%
EBITDA3,181,9112,373,450808,46134%2,007,702365,74818%1,174,20958%
Adjusted EBITDA3,151,8112,509,003642,80826%2,122,399386,60418%1,029,41249%
NOI3,160,9072,690,219470,68817%2,301,845388,37417%859,06237%
Per share data (fully diluted):
Net income attributable to common stockholders (1)$1.57$0.66$0.91138%$0.30$0.36120%$1.27423%
Funds from operations attributable to common stockholders$3.82$3.40$0.4212%$3.18$0.227%$0.6420%
Interest coverage ratio5.39x3.74x1.65x44%3.73x0.01x%1.66x45%
Fixed charge coverage ratio4.99x3.44x1.55x45%3.37x0.07x2%1.62x48%
Adjusted interest coverage ratio5.34x3.95x1.39x35%3.94x0.01x%1.40x36%
Adjusted fixed charge coverage ratio4.95x3.64x1.31x36%3.56x0.08x2%1.39x39%
(1) Includes adjustment to the numerator for income (loss) attributable to OP unitholders.

The following table represents the changes in outstanding common stock for the period from January 1, 2022 to December 31, 2024 (in thousands):

Year Ended December 31,
202420232022Totals
Beginning balance564,241490,508447,239447,239
Redemption of OP Units and DownREIT Units4953365836
Option exercises184224
ATM Program issuances70,42053,30143,093166,814
Equity issuances20,12520,125
Other, net115(33)169251
Ending balance635,289564,241490,508635,289
Weighted average number of shares outstanding:
Basic602,975515,629462,185
Diluted608,750518,701465,158

A portion of our earnings is derived primarily from long-term investments with predictable rates of return. These investments are mainly financed with a combination of equity, senior unsecured notes, secured debt and borrowings under our primary unsecured credit facility. During inflationary periods, which generally are accompanied by rising interest rates, our ability to grow may be adversely affected because the yield on new investments may increase at a slower rate than new borrowing costs.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Seniors Housing Operating

The following is a summary of our results of operations for the Seniors Housing Operating segment for the years presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
Revenues:
Resident fees and services$6,027,149$4,753,804$1,273,34527%$4,173,711$580,09314%$1,853,43844%
Other income8,3129,743(1,431)-15%63,839(54,096)-85%(55,527)-87%
Total revenues6,035,4614,763,5471,271,91427%4,237,550525,99712%1,797,91142%
Property operating expenses4,523,7803,655,508868,27224%3,292,045363,46311%1,231,73537%
NOI(1)1,511,6811,108,039403,64236%945,505162,53417%566,17660%
Other expenses:
Depreciation and amortization1,107,116906,771200,34522%854,80051,9716%252,31630%
Interest expense42,94956,509(13,560)-24%34,83321,67662%8,11623%
Loss (gain) on extinguishment of debt, net1,7111,711n/a386(386)-100%1,325343%
Impairment of assets85,56424,99960,565242%13,14611,85390%72,418551%
Other expenses96,43596,972(537)-1%66,02630,94647%30,40946%
1,333,7751,085,251248,52423%969,191116,06012%364,58438%
Income (loss) from continuing operations before income taxes and other items177,90622,788155,118681%(23,686)46,474196%201,592851%
Income (loss) from unconsolidated entities1,376(70,940)72,316102%(53,507)(17,433)-33%54,883103%
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net134,08268,29065,79296%5,79462,496n/a128,288n/a
Income (loss) from continuing operations313,36420,138293,226n/a(71,399)91,537128%384,763539%
Net income (loss)313,36420,138293,226n/a(71,399)91,537128%384,763539%
Less: Net income (loss) attributable to noncontrolling interests(2,694)(5,975)3,28155%(15,689)9,71462%12,99583%
Net income (loss) attributable to common stockholders$316,058$26,113$289,945n/a$(55,710)$81,823147%$371,768667%

(1) See Non-GAAP Financial Measures below.

Resident fees and services revenue and property operating expenses for the year ended December 31, 2024 increased compared to the prior year primarily due to acquisitions, construction conversions outpacing dispositions and the conversions of Triple-net properties to Seniors Housing Operating RIDEA structures throughout the year. Additionally, our Seniors Housing Operating revenues are dependent on occupancy and rate growth, both of which have continued to steadily increase during 2024. Average occupancy is as follows:

Three Months Ended(1)
March 31,June 30,September 30,December 31,
202379.0%79.6%80.7%82.2%
202482.5%82.8%83.8%84.8%

(1) Average occupancy includes our minority ownership share related to unconsolidated properties and excludes the minority partners' noncontrolling ownership share related to consolidated properties. Also excludes land parcels and properties under development.

The following is a summary of our SSNOI at Welltower's share for the Seniors Housing Operating segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2024December 31, 2023$%December 31, 2024December 31, 2023$%
SSNOI(1)$295,897$238,547$57,35024.0%$977,345$817,584$159,76119.5%

(1) Relates to 660 properties for the QTD Pool and 545 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

During the year ended December 31, 2024, we recorded impairment charges of $85,564,000 related to 18 properties. During the year ended December 31, 2023, we recorded impairment charges of $24,999,000 related to seven properties.

Transaction costs related to asset acquisitions are capitalized as a component of the purchase price. The fluctuation in other expenses is primarily due to the timing of noncapitalizable transaction costs associated with acquisitions and operator transitions. Changes in the gain on sales of properties are related to the volume and timing of property sales and the sales prices, which are further discussed in Note 5 to our consolidated financial statements.

Depreciation and amortization has increased as a result of acquisitions and segment transitions. To the extent we acquire or dispose of additional properties in the future, our provision for depreciation and amortization will change accordingly.

61

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

During the year ended December 31, 2024, we completed Seniors Housing Operating construction conversions representing $778,834,000 or $550,413 per unit. The following is a summary of our consolidated Seniors Housing Operating construction projects in process, excluding expansions, overhead and capitalized interest (dollars in thousands):

As of December 31, 2024
Expected Conversion Year(1)PropertiesUnits/BedsAnticipated Remaining FundingConstruction in Progress Balance
2025182,978$174,735$705,248
202691,321254,900105,684
TBD(2)346,665
Total30$857,597
(1) Properties expected to be converted in phases over multiple years are reflected in the last expected year.
(2) Represents projects for which a final budget or expected conversion date are not yet known.

Interest expense represents secured debt interest expense, which fluctuates based on the net effect and timing of assumptions, segment transitions, fluctuations in interest rates, extinguishments and principal amortizations. The fluctuations in loss (gain) on extinguishment of debt is primarily attributable to the volume of extinguishments and terms of the related secured debt.

The following is a summary of our Seniors Housing Operating segment property secured debt principal activity (dollars in thousands):

Year Ended December 31,
202420232022
Beginning balance$1,955,048$1,701,939$1,599,522
Debt transferred27,08432,478
Debt issued197,930385,115113,183
Debt assumed427,725381,837288,522
Debt extinguished(303,081)(486,825)(227,910)
Debt disposed(164,640)
Principal payments(41,220)(47,672)(47,399)
Foreign currency(56,263)20,654(56,457)
Ending balance$2,042,583$1,955,048$1,701,939
Ending weighted average interest4.29%4.68%4.32%

A portion of our Seniors Housing Operating property investments are formed through partnership interests. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. Income from unconsolidated entities during the year ended December 31, 2023 includes other-than-temporary impairment charges of $35,293,000, primarily related to unconsolidated management companies. Net income attributable to noncontrolling interests represents our partners’ share of net income (loss) related to joint ventures.

62

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Triple-net

The following is a summary of our results of operations for the Triple-net segment for the years presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
Revenues:
Rental income$777,297$814,751$(37,454)-5%$782,329$32,4224%$(5,032)-1%
Interest income8,1671,3696,798497%1,606(237)-15%6,561409%
Other income3,30770,986(67,679)-95%6,77664,210948%(3,469)-51%
Total revenues788,771887,106(98,335)-11%790,71196,39512%(1,940)%
Property operating expenses40,72242,194(1,472)-3%44,483(2,289)-5%(3,761)-8%
NOI(1)748,049844,912(96,863)-11%746,22898,68413%1,821%
Other expenses:
Depreciation and amortization258,830231,02827,80212%215,88715,1417%42,94320%
Interest expense6,918(65)6,983n/a963(1,028)-107%5,955618%
Loss (gain) on derivatives and financial instruments, net1298(86)-88%1,499(1,401)-93%(1,487)-99%
Loss (gain) on extinguishment of debt, netn/a80(80)-100%(80)-100%
Provision for loan losses, net297(297)-100%297n/an/a
Impairment of assets5,65811,098(5,440)-49%3,5957,503209%2,06357%
Other expenses10,7935,0605,733113%13,043(7,983)-61%(2,250)-17%
282,211247,51634,69514%235,06712,4495%47,14420%
Income (loss) from continuing operations before income taxes and other items465,838597,396(131,558)-22%511,16186,23517%(45,323)-9%
Income (loss) from unconsolidated entities(17,554)7,158(24,712)-345%29,255(22,097)-76%(46,809)-160%
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net309,453259309,194n/a16,648(16,389)-98%292,805n/a
Income (loss) from continuing operations757,737604,813152,92425%557,06447,7499%200,67336%
Net income (loss)757,737604,813152,92425%557,06447,7499%200,67336%
Less: Net income (loss) attributable to noncontrolling interests19,76421,804(2,040)-9%28,161(6,357)-23%(8,397)-30%
Net income (loss) attributable to common stockholders$737,973$583,009$154,96427%$528,903$54,10610%$209,07040%

(1) See Non-GAAP Financial Measures below.

Rental income decreased primarily due to agreements to convert Triple-net properties to Seniors Housing Operating RIDEA structures and the write-off of straight-line rent receivable balances of $139,652,000 and $16,642,000 during the years ended December 31, 2024 and 2023, respectively. These write-offs relate to leases for which the collection of substantially all contractual lease payments was no longer deemed probable, due primarily to agreements reached to convert Triple-net properties to Seniors Housing Operating RIDEA structures. These decreases are partially offset by acquisitions during the relevant periods.

Certain of our leases contain annual rental escalators that are contingent upon changes in the Consumer Price Index and/or changes in the gross operating revenues of the tenant’s properties. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. If gross operating revenues at our facilities and/or the Consumer Price Index do not increase, a portion of our revenues may not continue to increase. For the year ended December 31, 2024, we had 64 leases with rental rate increases ranging from 0.05% to 20.05% in our Triple-net portfolio.

Interest income primarily related to leases that were classified as sales-type leases in 2024.

As part of the substantial exit of the Genesis HealthCare operating relationship, which we disclosed on March 2, 2021, we transitioned the sublease of a portfolio of seven facilities from Genesis HealthCare to Complete Care Management in the second quarter of 2021. As part of the March 2021 transaction, we entered into a forward sale agreement for the seven properties valued at $182,618,000, which was expected to close when the Welltower-held purchase option became exercisable. As of March 31, 2023, the right of use assets related to the properties were $115,359,000 and were reflected as held for sale with the corresponding lease liabilities of $66,530,000 on our Consolidated Balance Sheet.

On May 1, 2023, we executed a series of transactions that included the assignment of the leasehold interest to a newly formed tri-party unconsolidated joint venture comprised of Aurora Health Network, Peace Capital (an affiliate of Complete Care Management) and us, and culminated with the closing of the purchase option by the joint venture. The transactions resulted in net cash proceeds to us of $104,240,000 after our retained interest of $11,571,000 in the joint venture and a gain from the loss of control and derecognition of the leasehold interest of $65,485,000, which we recorded in other income within our Consolidated Statements of Comprehensive Income during the year ended December 31, 2023.

63

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a summary of our SSNOI at Welltower's share for the Triple-net segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2024December 31, 2023$%December 31, 2024December 31, 2023$%
SSNOI(1)$146,864$141,036$5,8284.1%$530,520$508,056$22,4644.4%

(1) Relates to 482 properties for the QTD Pool and 450 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

Depreciation and amortization fluctuate as a result of the acquisitions, dispositions and segment transitions of Triple-net properties. To the extent we acquire or dispose of additional properties in the future, our provision for depreciation and amortization will change accordingly.

During the year ended December 31, 2024, we recorded impairment charges of $5,658,000 related to three properties. During the year ended December 31, 2023, we recorded impairment charges of $11,098,000 related to three properties.

Transaction costs related to asset acquisitions are capitalized as a component of purchase price. The fluctuation in other expenses is primarily due to noncapitalizable transaction costs from acquisitions and segment transitions. Changes in the gain on sales of properties are related to the volume and timing of property sales and the sales prices, which are further discussed in Note 5 to our consolidated financial statements.

Interest expense represents secured debt interest expense and related fees. The change in secured debt interest expense is due to the net effect and timing of assumptions, segment transitions, fluctuations in interest rates, extinguishments and principal amortizations. The following is a summary of our Triple-net secured debt principal activity for the periods presented (dollars in thousands):

Year Ended December 31,
202420232022
Beginning balance$38,260$39,179$72,536
Debt transferred(27,084)(32,478)
Debt assumed532,57539,574
Debt extinguished(10,628)(39,574)
Debt disposed(194,500)
Principal payments(3,071)(919)(879)
Ending balance$335,552$38,260$39,179
Ending weighted average interest3.44%4.39%4.39%

A portion of our Triple-net property investments were formed through partnerships. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. The decrease in income from unconsolidated entities during the year ended December 31, 2024 is primarily related to the hypothetical liquidation at book value ("HLBV") adjustments to our unconsolidated entities (refer Note 2 for additional information.) Net income attributable to noncontrolling interests represents our partners’ share of net income relating to those partnerships where we are the controlling partner.

64

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Outpatient Medical

The following is a summary of our results of operations for the Outpatient Medical segment for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
Revenues:
Rental income$792,981$741,322$51,6597%$669,457$71,86511%$123,52418%
Other income9,1329,167(35)%8,9981692%1341%
Total revenues802,113750,48951,6247%678,45572,03411%123,65818%
Property operating expenses245,636231,95613,6806%205,99725,95913%39,63919%
NOI(1)556,477518,53337,9447%472,45846,07510%84,01918%
Other expenses:
Depreciation and amortization266,147263,3022,8451%239,68123,62110%26,46611%
Interest expense1,15010,543(9,393)-89%18,078(7,535)-42%(16,928)-94%
Loss (gain) on extinguishment of debt, net7(7)-100%15(8)-53%(15)-100%
Impairment of assets1,5711,571n/a761(761)-100%810106%
Other expenses6482,289(1,641)-72%2,537(248)-10%(1,889)-74%
269,516276,141(6,625)-2%261,07215,0696%8,4443%
Income (loss) from continuing operations before income taxes and other item286,961242,39244,56918%211,38631,00615%75,57536%
Income (loss) from unconsolidated entities5,046(549)5,595n/a(2,626)2,07779%7,672292%
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net8,076(651)8,727n/a(6,399)5,74890%14,475226%
Income (loss) from continuing operations300,083241,19258,89124%202,36138,83119%97,72248%
Net income (loss)300,083241,19258,89124%202,36138,83119%97,72248%
Less: Net income (loss) attributable to noncontrolling interests1,3071,309(2)%6,919(5,610)-81%(5,612)-81%
Net income (loss) attributable to common stockholders$298,776$239,883$58,89325%$195,442$44,44123%$103,33453%

(1) See Non-GAAP Financial Measures below.

Rental income increased due primarily to acquisitions and construction conversions that occurred during 2023 and 2024. Certain of our leases contain annual rental escalators that are contingent upon changes in the Consumer Price Index. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. If the Consumer Price Index does not increase, a portion of our revenues may not continue to increase. Our leases could renew above or below current rental rates, resulting in an increase or decrease in rental income. For the year ended December 31, 2024, our consolidated Outpatient Medical portfolio signed 384,643 square feet of new leases and 1,992,131 square feet of renewals. The weighted average term of these leases was eight years, with a rate of $42.22 per square foot and tenant improvement and lease commission costs of $30.50 per square foot. Substantially all of these leases contain an annual fixed or contingent escalation rent structure ranging from 2.0% to 6.5%.

The fluctuations in property operating expenses and depreciation and amortization are primarily attributable to acquisitions and construction conversions that occurred during 2023 and 2024. To the extent that we acquire or dispose of additional properties in the future, these amounts will change accordingly.

The following is a summary of our SSNOI at Welltower share for the Outpatient Medical segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2024December 31, 2023$%December 31, 2024December 31, 2023$%
SSNOI(1)$129,752$128,417$1,3351.0%$481,635$472,136$9,4992.0%

(1) Relates to 415 properties for the QTD Pool and 379 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

During the year ended December 31, 2024, we recorded an impairment charge of $1,571,000 related to one property. No impairment was recorded in 2023.

Transaction costs related to asset acquisitions are capitalized as a component of purchase price. The fluctuation in other expenses is primarily due to noncapitalizable transaction costs. Changes in the gains/losses on sales of properties are related to the volume and timing of property sales and the sales prices, which are further discussed in Note 5 to our consolidated financial statements.

During the year ended December 31, 2024, we completed construction conversions representing $228,515,000 or $1,563 per square foot. The following is a summary of our consolidated Outpatient Medical construction projects in process, excluding expansions, overhead and capitalized interest (dollars in thousands):

65

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

As of December 31, 2024
Expected Conversion YearPropertiesSquare FeetAnticipated Remaining FundingConstruction in Progress Balance
20257646,940$110,664$256,505
TBD(1)134,132
Total8$290,637
(1) Represents projects for which a final budget or expected conversion date are not yet known.

Total interest expense represents secured debt interest expense. The change in secured debt interest expense is primarily due to the net effect and timing of assumptions, fluctuations in interest rates, extinguishments and principal amortizations. The following is a summary of our Outpatient Medical secured debt principal activity (dollars in thousands):

Year Ended December 31,
202420232022
Beginning balance$229,137$388,836$530,254
Debt assumed46,741
Debt extinguished(137,011)(200,955)(131,582)
Principal payments(3,038)(5,485)(9,836)
Ending balance$89,088$229,137$388,836
Ending weighted average interest4.19%5.42%4.38%

A portion of our Outpatient Medical property investments were formed through partnerships. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. The increase from prior year is attribute to the gain recognized as part of the sale of one our unconsolidated properties. Net income attributable to noncontrolling interests represents our partners’ share of net income or loss relating to those partnerships where we are the controlling partner.

Non-segment/Corporate

The following is a summary of our results of operations for the Non-segment/Corporate activities for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
Revenues:
Interest income$248,024$166,985$81,03949%$148,965$18,02012%$99,05966%
Other income116,74969,86846,88167%4,93464,934n/a111,815n/a
Total revenues364,773236,853127,92054%153,89982,95454%210,874137%
Property operating expenses20,07318,1181,95511%16,2451,87312%3,82824%
NOI(1)344,700218,735125,96558%137,65481,08159%207,046150%
Other expenses:
Interest expense523,244540,859(17,615)-3%475,64565,21414%47,59910%
General and administrative expenses235,491179,09156,40031%150,39028,70119%85,10157%
Loss (gain) on derivatives and financial instruments, net(27,899)(2,218)(25,681)n/a6,835(9,053)-132%(34,734)-508
Loss (gain) on extinguishments of debt, net419419n/a199(199)-100%220111%
Provision for loan losses, net10,1259,5126136%10,320(808)-8%(195)-2%
Other expenses9,5834,0205,563138%20,064(16,044)-80%(10,481)-52%
Total expenses750,963731,26419,6993%663,45367,81110%87,51013%
Loss from continuing operations before income taxes and other items(406,263)(512,529)106,26621%(525,799)13,2703%119,53623%
Income (loss) from unconsolidated entities10,63610,889(253)-2%5,5885,30195%5,04890%
Income tax (expense) benefit(2,700)(6,364)3,66458%(7,247)88312%4,54763%
Loss from continuing operations(398,327)(508,004)109,67722%(527,458)19,4544%129,13124%
Net income (loss)(398,327)(508,004)109,67722%(527,458)19,4544%129,13124%
Less: Net income (loss) attributable to noncontrolling interests2,8009071,893209%(37)944n/a2,837n/a
Net loss attributable to common stockholders$(401,127)$(508,911)$107,78421%$(527,421)$18,5104%$126,29424%

(1) See Non-GAAP Financial Measures below.

The increase in interest income during the year ended December 31, 2024 is primarily driven by increased advances on loans receivable during the year.

66

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The increase in other income for the year ended December 31, 2024 is primarily due to interest earned on deposits. Property operating expenses represent insurance costs related to our captive insurance company, which acts as a direct insurer of property level insurance coverage for our portfolio.

The following is a summary of our Non-segment/Corporate interest expense for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
Senior unsecured notes$497,223$508,681$(11,458)-2%$436,185$72,49617%$61,03814%
Unsecured credit facility and commercial paper program6,2396,977(738)-11%19,576(12,599)-64%(13,337)-68%
Loan expense19,78225,201(5,419)-22%19,8845,31727%(102)-1%
Totals$523,244$540,859$(17,615)-3%$475,645$65,21414%$47,59910%

The change in interest expense on senior unsecured notes is due to the net effect of issuances and extinguishments, as well as the movement in foreign exchange rates and related hedge activity. Please refer to Note 11 to the consolidated financial statements for additional information. The change in interest expense on our unsecured revolving credit facility and commercial paper program is due primarily to the net effect and timing of draws, paydowns and variable interest rate changes. Please refer to Note 10 of our consolidated financial statements for additional information regarding our unsecured revolving credit facility and commercial paper program. Loan expenses represent the amortization of costs incurred in connection with senior unsecured notes issuances.

General and administrative expenses as a percentage of consolidated revenues for the years ended December 31, 2024, 2023 and 2022 were 2.95%, 2.70% and 2.57%, respectively. The increase during the year ended December 31, 2024 is primarily driven by compensation costs associated with increased employee headcount. During the three months ended September 30, 2024, we also recognized $29,838,000 as a cumulative catch up of stock compensation expense due to the change in the probability of achievement of specific performance goals related to special nonrecurring performance-based stock option and restricted stock awards granted in December 2021 and January 2022. Please refer to Note 15 for additional information related to these grants.

Other expenses includes noncapitalizable legal expenses. The provision for income taxes primarily relates to state taxes, foreign taxes and taxes based on income generated by entities that are structured as taxable REIT subsidiaries.

Loss (gain) on derivatives and financial instruments, net is primarily attributable to the mark-to-market of the equity warrants received as part of the HC-One Group transactions that closed in 2021 and 2023.

Other

Non-GAAP Financial Measures

We believe that net income and net income attributable to common stockholders, as defined by U.S. GAAP, are the most appropriate earnings measurements. However, we consider FFO, NOI, SSNOI, EBITDA and Adjusted EBITDA to be useful supplemental measures of our operating performance. Historical cost accounting for real estate assets in accordance with U.S. GAAP implicitly assumes that the value of real estate assets diminishes predictably over time as evidenced by the provision for depreciation. However, since real estate values have historically risen or fallen with market conditions, many industry investors and analysts have considered presentations of operating results for real estate companies that use historical cost accounting to be insufficient. In response, the National Association of Real Estate Investment Trusts ("NAREIT") created funds from operations attributable to common stockholders ("FFO") as a supplemental measure of operating performance for REITs that excludes historical cost depreciation from net income. FFO, as defined by NAREIT, means NICS, computed in accordance with U.S. GAAP, excluding gains (or losses) from sales of real estate and acquisitions of controlling interests, and impairment of depreciable assets, plus depreciation and amortization, and after adjustments for unconsolidated entities and noncontrolling interests.

NOI is used to evaluate the operating performance of our properties. We define NOI as total revenues, including tenant reimbursements, less property operating expenses. Property operating expenses represent costs associated with managing, maintaining, and servicing tenants for our properties. These expenses include, but are not limited to, property-related payroll and benefits, property management fees paid to managers, marketing, housekeeping, food service, maintenance, utilities, property taxes and insurance. General and administrative expenses represent general overhead costs that are unrelated to property operations and unallocable to the properties. These expenses include, but are not limited to, payroll and benefits related to corporate employees, professional services, office expenses and depreciation of corporate fixed assets. Same store NOI ("SSNOI") is used to evaluate the operating performance of our properties using a consistent population which controls for changes in the composition of our portfolio. We believe the drivers of property level NOI for both consolidated properties and unconsolidated properties are generally the same and therefore, we evaluate SSNOI based on our ownership interest in each property ("Welltower Share"). To arrive at Welltower's Share, NOI is adjusted by adding our minority ownership share related to unconsolidated properties and by subtracting the minority partners' noncontrolling ownership interests for consolidated properties. We do not control investments in unconsolidated properties and while we consider disclosures at Welltower Share to

67

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

be useful, they may not accurately depict the legal and economic implications of our joint venture arrangements and should be used with caution. As used herein, same store is generally defined as those revenue-generating properties in the portfolio for the relevant year-over-year reporting periods. Acquisitions and development conversions are included in SSNOI five full quarters or eight full quarters after acquisition or being placed into service for the QTD Pool and the YTD Pool, respectively. Land parcels, loans and leased properties, as well as any properties sold or classified as held for sale during the respective periods are excluded from SSNOI. Redeveloped properties (including major refurbishments of a Seniors Housing Operating property where 20% or more of units are simultaneously taken out of commission for 30 days or more or Outpatient Medical properties undergoing a change in intended use) are excluded from SSNOI until five full quarters or eight full quarters post completion of the redevelopment for the QTD Pool and YTD Pool, respectively. Properties undergoing operator transitions and/or segment transitions are also excluded from SSNOI until five full quarters or eight full quarters post completion of the transition for the QTD Pool and YTD Pool, respectively. In addition, properties significantly impacted by force majeure, acts of God, or other extraordinary adverse events are excluded from SSNOI until five full quarters or eight full quarters after the properties are placed back into service for the QTD Pool and YTD Pool, respectively. SSNOI excludes non-cash NOI and includes adjustments to present consistent ownership percentages and to translate Canadian properties and U.K. properties using a consistent exchange rate. We believe NOI and SSNOI provide investors relevant and useful information because they measure the operating performance of our properties at the property level on an unleveraged basis. We use NOI and SSNOI to make decisions about resource allocations and to assess the property level performance of our properties.

EBITDA is defined as earnings (net income) before interest, taxes, depreciation and amortization. Adjusted EBITDA is defined as EBITDA excluding unconsolidated entities and including adjustments for stock-based compensation expense, provision for loan losses, gains/losses on extinguishment of debt, gains/losses on disposition of properties and acquisitions of controlling interests, impairment of assets, gains/losses on derivatives and financial instruments, other expenses, other impairment charges and other adjustments as deemed appropriate. We believe that EBITDA and Adjusted EBITDA, along with net income, are important supplemental measures because they provide additional information to assess and evaluate the performance of our operations. We primarily use these measures to determine our interest coverage ratio, which represents EBITDA and Adjusted EBITDA divided by total interest, and our fixed charge coverage ratio, which represents EBITDA and Adjusted EBITDA divided by fixed charges. Fixed charges include total interest and secured debt principal amortization. Covenants in our unsecured senior notes and primary credit facility contain financial ratios based on a definition of EBITDA and Adjusted EBITDA that is specific to those agreements. Our leverage ratios are defined as the proportion of net debt to total capitalization and include book capitalization, undepreciated book capitalization and enterprise value. Book capitalization represents the sum of net debt (defined as total long-term debt, excluding operating lease liabilities, less cash and cash equivalents and restricted cash), total equity and redeemable noncontrolling interests. Undepreciated book capitalization represents book capitalization adjusted for accumulated depreciation and amortization. Enterprise value represents book capitalization adjusted for the fair market value of our common stock.

Our supplemental reporting measures and similarly entitled financial measures are widely used by investors, equity and debt analysts and rating agencies in the valuation, comparison, rating and investment recommendations of companies. Management uses these financial measures to facilitate internal and external comparisons to our historical operating results and in making operating decisions. Additionally, the Board of Directors utilizes these measures to evaluate management performance. None of our supplemental measures represent net income or cash flow provided from operating activities as determined in accordance with U.S. GAAP and should not be considered as alternative measures of profitability or liquidity. Finally, the supplemental measures, as defined by us, may not be comparable to similarly entitled items reported by other real estate investment trusts or other companies.

68

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The table below reflects the reconciliation of FFO to NICS, the most directly comparable U.S. GAAP measure, for the periods presented. Noncontrolling interest and unconsolidated entity amounts represent adjustments to reflect our share of depreciation and amortization, gains/loss on real estate dispositions and impairment of assets. Amounts are in thousands except for per share data.

Year Ended December 31,
FFO Reconciliation:202420232022
Net income attributable to common stockholders$951,680$340,094$141,214
Depreciation and amortization1,632,0931,401,1011,310,368
Impairment of assets92,79336,09717,502
Loss (gain) on real estate dispositions and acquisitions of controlling interests, net(451,611)(67,898)(16,043)
Noncontrolling interests(30,812)(46,393)(56,529)
Unconsolidated entities129,290100,22681,560
Funds from operations attributable to common stockholders$2,323,433$1,763,227$1,478,072
Average diluted shares outstanding:608,750518,701465,158
Per diluted share data:
Net income attributable to common stockholders(1)$1.57$0.66$0.30
Funds from operations attributable to common stockholders$3.82$3.40$3.18
(1) Includes adjustment to the numerator for income (loss) attributable to OP Unitholders.

The tables below reflects the reconciliation of consolidated NOI to net income, the most directly comparable U.S. GAAP measure, for the years presented (dollars in thousands):

Year Ended December 31,
NOI Reconciliation:202420232022
Net income (loss)$972,857$358,139$160,568
Loss (gain) on real estate dispositions and acquisitions of controlling interests, net(451,611)(67,898)(16,043)
Loss (income) from unconsolidated entities49653,44221,290
Income tax expense (benefit)2,7006,3647,247
Other expenses117,459108,341101,670
Impairment of assets92,79336,09717,502
Provision for loan losses, net10,1259,80910,320
Loss (gain) on extinguishment of debt, net2,1307680
Loss (gain) on derivatives and financial instruments, net(27,887)(2,120)8,334
General and administrative expenses235,491179,091150,390
Depreciation and amortization1,632,0931,401,1011,310,368
Interest expense574,261607,846529,519
Consolidated net operating income (NOI)$3,160,907$2,690,219$2,301,845
NOI by segment:
Seniors Housing Operating$1,511,681$1,108,039$945,505
Triple-net748,049844,912746,228
Outpatient Medical556,477518,533472,458
Non-segment/Corporate344,700218,735137,654
Total NOI$3,160,907$2,690,219$2,301,845

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Quarterly NOI by Segment:
(in thousands)Three Months EndedYear Ended
March 31,June 30,September 30,December 31,December 31,
2024202320242023202420232024202320242023
Seniors Housing Operating:
Total revenues$1,361,737$1,134,130$1,395,373$1,162,344$1,514,022$1,201,705$1,764,329$1,265,368$6,035,461$4,763,547
Property operating expenses1,019,347883,7841,034,906885,1871,135,887918,9901,333,640967,5474,523,7803,655,508
Consolidated NOI$342,390$250,346$360,467$277,157$378,135$282,715$430,689$297,821$1,511,681$1,108,039
Triple-net:
Total revenues$222,943$204,709$142,082$266,015$228,649$196,809$195,097$219,573$788,771$887,106
Property operating expenses10,81711,72310,49510,5989,34510,04410,0659,82940,72242,194
Consolidated NOI$212,126$192,986$131,587$255,417$219,304$186,765$185,032$209,744$748,049$844,912
Outpatient Medical:
Total revenues$198,310$184,740$197,237$186,097$204,995$191,860$201,571$187,792$802,113$750,489
Property operating expenses62,46358,36561,18558,69762,77862,20459,21052,690245,636231,956
Consolidated NOI$135,847$126,375$136,052$127,400$142,217$129,656$142,361$135,102$556,477$518,533
Non-segment/Corporate:
Total revenues$76,751$37,150$90,192$51,022$107,997$71,639$89,833$77,042$364,773$236,853
Property operating expenses4,2863,8814,7114,1904,6914,0356,3856,01220,07318,118
Consolidated NOI$72,465$33,269$85,481$46,832$103,306$67,604$83,448$71,030$344,700$218,735

70

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a reconciliation of the properties included in our QTD Pool and YTD Pool for SSNOI:

QTD PoolYTD Pool
SSNOI Property Reconciliations:Seniors Housing OperatingTriple-netOutpatient MedicalTotalSeniors Housing OperatingTriple-netOutpatient MedicalTotal
Consolidated properties1,1565923712,1191,1565923712,119
Unconsolidated properties76761527676152
Total properties1,2325924472,2711,2325924472,271
Recent acquisitions and development conversions(1)(167)(74)(12)(253)(282)(106)(48)(436)
Under development(34)(8)(42)(34)(8)(42)
Under redevelopment(2)(2)(4)(2)(8)(2)(4)(2)(8)
Current held for sale(22)(1)(23)(22)(1)(23)
Land parcels, loans and leased properties(105)(8)(9)(122)(105)(8)(9)(122)
Transitions(3)(234)(19)(253)(234)(19)(253)
Other(4)(8)(4)(1)(13)(8)(4)(1)(13)
Same store properties6604824151,5575454503791,374
(1) Acquisitions and development conversions will enter the QTD Pool five full quarters and the YTD Pool eight full quarters after acquisition or certificate of occupancy.
(2) Redevelopment properties will enter the QTD Pool after five full quarters and the YTD Pool after eight full quarters of operations post redevelopment completion.
(3) Transitioned properties will enter the QTD Pool after five full quarters and the YTD Pool after eight full quarters of operations with the new operator in place or under the new structure.
(4) Represents properties that are either closed or being closed.

71

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a reconciliation of our consolidated NOI to same store NOI for the periods presented for the respective pools (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedTwelve Months Ended
SSNOI Reconciliations:December 31, 2024December 31, 2023December 31, 2024December 31, 2023
Seniors Housing Operating:
Consolidated NOI$430,689$297,821$1,511,681$1,108,039
NOI attributable to unconsolidated investments23,28220,48890,81265,281
NOI attributable to noncontrolling interests(12,369)(15,688)(52,437)(62,838)
NOI attributable to non-same store properties(143,604)(62,817)(571,693)(294,139)
Non-cash NOI attributable to same store properties(1,834)(2,757)(756)(2,328)
Currency and ownership adjustments (1)(267)1,500(262)3,569
SSNOI at Welltower Share295,897238,547977,345817,584
Triple-net:
Consolidated NOI185,032209,744748,049844,912
NOI attributable to unconsolidated investments5,7113,5049,901
NOI attributable to noncontrolling interests(5,314)(12,584)(29,387)(31,361)
NOI attributable to non-same store properties(56,108)(38,316)(172,633)(240,832)
Non-cash NOI attributable to same store properties23,533(25,647)(23,865)(82,917)
Currency and ownership adjustments (1)(279)2,1284,8528,353
SSNOI at Welltower Share146,864141,036530,520508,056
Outpatient Medical:
Consolidated NOI142,361135,102556,477518,533
NOI attributable to unconsolidated investments4,0994,58617,24418,925
NOI attributable to noncontrolling interests(2,491)(2,308)(9,898)(15,400)
NOI attributable to non-same store properties(8,742)(3,607)(63,145)(35,787)
Non-cash NOI attributable to same store properties(5,488)(5,433)(19,100)(20,404)
Currency and ownership adjustments (1)1377576,269
SSNOI at Welltower Share129,752128,417481,635472,136
SSNOI at Welltower Share:
Seniors Housing Operating295,897238,547977,345817,584
Triple-net146,864141,036530,520508,056
Outpatient Medical129,752128,417481,635472,136
Total$572,513$508,000$1,989,500$1,797,776
(1) Includes adjustments to reflect consistent property ownership percentages, to translate Canadian properties at a USD/CAD rate of 1.36 and to translate U.K. properties at a GBP/USD rate of 1.25.

72

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The table below reflects the reconciliation of EBITDA and Adjusted EBITDA to net income, the most directly comparable U.S. GAAP measure, for the periods presented. Dollars are in thousands.

Year Ended December 31,
Adjusted EBITDA Reconciliation:202420232022
Net income (loss)$972,857$358,139$160,568
Interest expense574,261607,846529,519
Income tax expense (benefit)2,7006,3647,247
Depreciation and amortization1,632,0931,401,1011,310,368
EBITDA3,181,9112,373,4502,007,702
Loss (income) from unconsolidated entities49653,44221,290
Stock-based compensation expense74,48236,61126,027
Loss (gain) on extinguishment of debt, net2,1307680
Loss (gain) on real estate dispositions and acquisitions of controlling interests, net(451,611)(67,898)(16,043)
Impairment of assets92,79336,09717,502
Provision for loan losses, net10,1259,80910,320
Loss (gain) on derivatives and financial instruments, net(27,887)(2,120)8,334
Other expenses117,459108,341101,670
Lease termination and leasehold interest adjustment (1)(65,485)(64,854)
Casualty losses, net of recoveries12,26110,10710,391
Other impairment, net (2)139,65216,642(620)
Adjusted EBITDA$3,151,811$2,509,003$2,122,399
Adjusted Interest Coverage Ratio:
Interest expense$574,261$607,846$529,519
Capitalized interest58,11550,69930,491
Non-cash interest expense(42,388)(23,494)(21,754)
Total interest589,988635,051538,256
EBITDA$3,181,911$2,373,450$2,007,702
Interest coverage ratio5.39x3.74x3.73x
Adjusted EBITDA$3,151,811$2,509,003$2,122,399
Adjusted interest coverage ratio5.34x3.95x3.94x
Adjusted Fixed Charge Coverage Ratio:
Total interest$589,988$635,051$538,256
Secured debt principal payments47,32954,07658,114
Total fixed charges637,317689,127596,370
EBITDA$3,181,911$2,373,450$2,007,702
Fixed charge coverage ratio4.99x3.44x3.37x
Adjusted EBITDA$3,151,811$2,509,003$2,122,399
Adjusted fixed charge coverage ratio4.95x3.64x3.56x

(1) Primarily relates to the derecognition of leasehold interests and the gain recognized in other income.

(2) Represents the write-off or recovery of straight-line rent receivables balances relating to leases placed on cash recognition.

73

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Our leverage ratios include book capitalization, undepreciated book capitalization and enterprise value. Book capitalization represents the sum of net debt (defined as total long-term debt excluding operating lease liabilities, less cash and cash equivalents and restricted cash), total equity and redeemable noncontrolling interests. Undepreciated book capitalization represents book capitalization adjusted for accumulated depreciation and amortization. Enterprise value represents book capitalization adjusted for the fair market value of our common stock. Our leverage ratios are defined as the proportion of net debt to total capitalization. The table below reflects the reconciliation of our leverage ratios to our balance sheets for the periods presented. Amounts are in thousands, except share price.

Year Ended December 31,
202420232022
Book capitalization:
Unsecured credit facility and commercial paper$$$
Long-term debt obligations(1)15,608,29415,815,22614,661,552
Cash and cash equivalents and restricted cash(3,711,457)(2,076,083)(722,292)
Total net debt11,896,83713,739,14313,939,260
Total equity and noncontrolling interests(2)32,572,58626,371,72721,393,996
Book capitalization$44,469,423$40,110,870$35,333,256
Net debt to book capitalization ratio26.8%34.3%39.5%
Undepreciated book capitalization:
Total net debt$11,896,837$13,739,143$13,939,260
Accumulated depreciation and amortization10,626,2639,274,8148,075,733
Total equity and noncontrolling interests(2)32,572,58626,371,72721,393,996
Undepreciated book capitalization$55,095,686$49,385,684$43,408,989
Net debt to undepreciated book capitalization ratio21.6%27.8%32.1%
Enterprise value:
Common shares outstanding635,289564,241490,509
Period end share price$126.03$90.17$65.55
Common equity market capitalization$80,065,473$50,877,611$32,152,865
Total net debt11,896,83713,739,14313,939,260
Noncontrolling interests(2)616,378967,3511,099,182
Consolidated enterprise value$92,578,688$65,584,105$47,191,307
Net debt to consolidated enterprise value ratio12.9%20.9%29.5%

(1) Amounts include senior unsecured notes, secured debt and lease liabilities related to finance leases, as reflected on our Consolidated Balance Sheets. Operating lease liabilities related to ASC 842 are excluded.

(2) Includes amounts attributable to both redeemable noncontrolling interests and noncontrolling interests as reflected on our Consolidated Balance Sheets.

Critical Accounting Policies and Estimates

Our consolidated financial statements are prepared in accordance with U.S. GAAP, which requires us to make estimates and assumptions. Management considers an accounting estimate or assumption critical if:

•the nature of the estimates or assumptions is material due to the levels of subjectivity and judgment necessary to account for highly uncertain matters or the susceptibility of such matters to change; and

•the impact of the estimates and assumptions on financial condition or operating performance is material.

Management has discussed the development and selection of its critical accounting policies and estimates with the Audit Committee of the Board of Directors. Management believes the current assumptions and other considerations used to estimate amounts reflected in our consolidated financial statements are appropriate and are not reasonably likely to change in the future. However, since these estimates require assumptions to be made that were uncertain at the time the estimate was made, they bear the risk of change. If actual experience differs from the assumptions and other considerations used in estimating amounts reflected in our consolidated financial statements, the resulting changes could have a material adverse effect on our consolidated results of operations, liquidity and/or financial condition. Please refer to Note 2 to our consolidated financial statements for further information on significant accounting policies that impact us and for the impact of new accounting standards, including accounting pronouncements that were issued but not yet adopted by us.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following table presents information about our critical accounting policies and estimates:

Nature of Critical Accounting EstimateAssumptions/Approach Used
Impairment of Real Property Owned and Investments in Unconsolidated EntitiesAssessing impairment of real property owned and investments in unconsolidated entities involves subjectivity in determining if indicators of impairment are present and in estimating the future undiscounted cash flows or estimated fair value of an asset. The evaluation of indicators of impairment is dependent on a number of factors, including when there is an unfavorable change in the operating performance of the property, a change in management's intent to hold and operate the property or a change in the property's use. If an indicator of impairment of the property is identified, management estimates whether the carrying value is recoverable using observable and unobservable inputs such as historical and forecasted cash flows and estimated capitalization rates, all of which are affected by our expectations of future market or economic conditions. These inputs can have a significant impact on the undiscounted cash flows. The evaluation of indicators of impairment of investments in unconsolidated entities is dependent on a number of factors including the performance of each investment, a change in market conditions or a change in management's investment strategy. When required, we estimate the fair value of an investment and, if such fair value is lower than carrying value, assess whether any impairment is other-than-temporary using observable and unobservable inputs such as historical and forecasted cash flows and estimated capitalization rates. These inputs can have a significant impact on the calculation of the fair value of the investment.Quarterly, we review our real property owned on a property by property basis to determine if facts and circumstances suggest the property may be impaired. These indicators may include expected operational performance, the tenant's ability to make rent payments, a change in management's intent to hold and operate the property and changes in the market that may permanently reduce the value of the property. If indicators of impairment exist, an undiscounted cash flow analysis will be prepared to determine if the value of the property will be recoverable. If the estimated undiscounted cash flows indicate that the carrying value of the property will not be recoverable, the carrying value of the property is reduced to its estimated fair value and an impairment charge is recognized for the difference between the carrying value and the fair value. The analysis requires us to use judgment in determining whether indicators of impairment exist and to estimate the expected future undiscounted cash flows or estimated fair values of the property. Properties that meet the held for sale criteria are recorded at the lesser of the fair value less costs to sell or carrying value.We also evaluate investments in unconsolidated entities for indicators of impairment and, when present, record impairment charges based on a comparison of the estimated fair value of the equity method investment to its carrying value if the decline in the estimated fair value of such an investment below its carrying value is other-than-temporary. At December 31, 2024, our net real property owned was approximately $40,673,242,000 and investments in unconsolidated entities totaled $1,768,772,000. During the year ended December 31, 2024, we recorded impairment charges of $92,793,000 related to 18 Seniors Housing Operating properties, three Triple-net properties and one Outpatient Medical property. No impairment losses related to investments in unconsolidated entities were recorded during the year ended December 31, 2024.

75

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Nature of Critical Accounting EstimateAssumptions/Approach Used
Real Estate AcquisitionsMost of our real estate acquisitions are considered asset acquisitions for which we record the related real estate acquired (tangible assets and identifiable intangible assets and liabilities) at cost on a relative fair value basis. Liabilities assumed and any associated noncontrolling interests are reflected at fair value. Tangible assets consist primarily of land, building and improvements. Identifiable intangible assets and liabilities primarily consist of the above or below market component of in-place leases and the value of in-place leases. The total amount of other intangible assets acquired is further allocated to in-place lease values and customer relationship values based on management's evaluation of the specific characteristics of each tenant's lease and our overall relationship with respect to that tenant. For real estate acquisitions accounted for as business combinations, we allocate the acquisition consideration to the assets acquired, liabilities assumed and noncontrolling interests at fair value as of the acquisition date. Any excess of the consideration transferred relative to the fair value of the net assets acquired is accounted for as goodwill.In determining the fair values that drive the recorded tangible assets and identifiable intangible assets and liabilities, we estimate the fair value of each component of the real estate acquired, which generally includes land, buildings and improvements, the above or below market component of in-place leases and the value of in-place leases using a number of sources including independent appraisals, our own analysis of recently acquired or developed and existing comparable properties in our portfolio and other market data. Significant assumptions used to determine such fair values include comparable land sales, capitalization rates, discount rates, market rental rates and property operating data, all of which can be impacted by expectations about future market or economic conditions. Our estimates of the values of these components affect the amount of depreciation and amortization we record over the estimated useful life of the property or the term of the lease and the amount of goodwill recognized in an acquisition accounted for as a business combination.During the year ended December 31, 2024, we disbursed $3,525,449,000 of cash related to real estate asset acquisitions and business combinations.

76

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Nature of Critical Accounting EstimateAssumptions/Approach Used
Principles of ConsolidationThe consolidated financial statements include our accounts, the accounts of our wholly owned subsidiaries and the accounts of joint venture entities in which we own a majority voting interest with the ability to control operations and where no substantive participating rights or substantive kick out rights have been granted to the noncontrolling interests. In addition, we consolidate those entities deemed to be variable interest entities (“VIEs”) in which we are determined to be the primary beneficiary. All material intercompany transactions and balances have been eliminated in consolidation.We make judgments about which entities are VIEs based on an assessment of whether (i) the equity investors as a group, if any, do not have a controlling financial interest or (ii) the equity investment at risk is insufficient to finance that entity’s activities without additional subordinated financial support. We make judgments with respect to our level of influence or control of an entity and whether we are (or are not) the primary beneficiary of a VIE. Consideration of various factors include, but is not limited to, our ability to direct the activities that most significantly impact the entity's economic performance, our form of ownership interest, our representation on the entity's governing body, the size and seniority of our investment, our ability and the rights of other investors to participate in policy making decisions, replace the manager and/or liquidate the entity, if applicable. Our ability to correctly assess our influence or control over an entity at inception of our involvement or on a continuous basis when determining the primary beneficiary of a VIE affects the presentation of these entities in our consolidated financial statements. If we perform a primary beneficiary analysis at a date other than at inception of the VIE, our assumptions may be different and may result in the identification of a different primary beneficiary.
Allowance for Credit Losses on Loans ReceivableThe allowance for credit losses is maintained at a level believed adequate to absorb potential losses in our loans receivable. The determination of the credit allowance is based on a quarterly evaluation of all outstanding loans, including general economic conditions and estimated collectability of loan payments.We evaluate the collectability of our loans receivable based on a combination of factors, including, but not limited to, payment status, historical loan charge-offs, financial strength of the borrower and guarantors, and nature, extent and value of the underlying collateral. A loan is considered to have deteriorated credit quality when, based on current information and events, it is probable that we will be unable to collect all amounts due as scheduled according to the contractual terms of the loan agreement. For those loans we identified as having deteriorated credit quality, we determine the amount of credit loss on an individual basis. Placement on non-accrual status may be required. Consistent with this definition, all loans on non-accrual are deemed to have deteriorated credit quality. To the extent circumstances improve and the risk of collectability is diminished, we may return these loans to income accrual status. While a loan is on non-accrual status, any cash receipts are applied against the outstanding principal balance. For the remaining loans, we assess credit loss on a collective pool basis and use our historical loss experience for similar loans to determine the reserve for credit losses.During the year ended December 31, 2024, we recognized provision for loan losses of $10,125,000, which includes changes in the reserve based on our historical loss experience.

FY 2023 10-K MD&A

SEC filing source: 0000766704-24-000008.

Extracted structurally from real Item 7 body heading to real Item 7A/8 boundary. Confidence: high. Filing date: 2024-02-15. Report date: 2023-12-31.

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

EXECUTIVE SUMMARY
Company Overview51
Business Strategy51
Key Transactions52
Key Performance Indicators, Trends and Uncertainties53
Corporate Governance55
LIQUIDITY AND CAPITAL RESOURCES
Sources and Uses of Cash55
Off-Balance Sheet Arrangements56
Contractual Obligations56
Capital Structure56
Supplemental Guarantor Information57
RESULTS OF OPERATIONS
Summary58
Seniors Housing Operating59
Triple-net61
Outpatient Medical63
Non-Segment/Corporate64
OTHER
Non-GAAP Financial Measures65
Critical Accounting Policies and Estimates71

50

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following discussion and analysis is based primarily on the consolidated financial statements of Welltower Inc. presented in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for the periods presented and should be read together with the notes thereto contained in this Annual Report on Form 10-K. Other important factors are identified in “Item 1 — Business” and “Item 1A — Risk Factors” above.

On March 7, 2022, we announced our intent to complete an UPREIT reorganization. In February 2022, the company formerly known as Welltower Inc. ("Old Welltower") formed WELL Merger Holdco Inc. ("New Welltower") as a wholly owned subsidiary, and New Welltower formed WELL Merger Holdco Sub Inc. ("Merger Sub") as a wholly owned subsidiary. On April 1, 2022, Merger Sub merged with and into Old Welltower, with Old Welltower continuing as the surviving corporation and a wholly owned subsidiary of New Welltower (the "Merger"). In connection with the Merger, Old Welltower's name was changed to "Welltower OP Inc.", and New Welltower inherited the name "Welltower Inc." Effective May 24, 2022, Welltower OP Inc. ("Welltower OP") converted from a Delaware corporation into a Delaware limited liability company named Welltower OP LLC (the "LLC Conversion"). Following the LLC Conversion, New Welltower's business continues to be conducted through Welltower OP and New Welltower does not have substantial assets or liabilities, other than through its investment in Welltower OP.

Unless stated otherwise or the context otherwise requires, references to "Welltower" mean Welltower Inc. and references to "Welltower OP" mean Welltower OP LLC. References to "we," "us" and "our" mean collectively Welltower, Welltower OP and those entities/subsidiaries owned or controlled by Welltower and/or Welltower OP.

Executive Summary

Company Overview

Welltower Inc. (NYSE:WELL), a real estate investment trust ("REIT") and S&P 500 company headquartered in Toledo, Ohio, is driving the transformation of health care infrastructure. Welltower invests with leading seniors housing operators, post-acute providers and health systems to fund the real estate and infrastructure needed to scale innovative care delivery models and improve people’s wellness and overall health care experience. Welltower owns interests in properties concentrated in major, high-growth markets in the United States ("U.S."), Canada and the United Kingdom ("U.K."), consisting of seniors housing and post-acute communities and outpatient medical properties.

Welltower is the initial member and majority owner of Welltower OP, with an approximate ownership interest of 99.765% as of December 31, 2023. All of our property ownership, development and related business operations are conducted through Welltower OP and Welltower has no material assets or liabilities other than its investment in Welltower OP. Welltower issues equity from time to time, the net proceeds of which it is obligated to contribute as additional capital to Welltower OP. All debt including credit facilities, senior notes and secured debt is incurred by Welltower OP and its subsidiaries, and Welltower has fully and unconditionally guaranteed all existing senior unsecured notes.

The following table summarizes our consolidated portfolio for the year ended December 31, 2023 (dollars in thousands):

Percentage ofNumber of
Type of PropertyNOI(1)NOIProperties
Seniors Housing Operating$1,118,13542.4%918
Triple-net1,001,13537.9%614
Outpatient Medical519,19919.7%369
Totals$2,638,469100.0%1,901

(1) Represents consolidated net operating income ("NOI") and excludes our share of investments in unconsolidated entities. Entities in which we have a joint venture with a minority partner are shown at 100% of the joint venture amount. See Non-GAAP Financial Measures for additional information and reconciliation.

Business Strategy

Our primary objectives are to protect stockholder capital and enhance stockholder value. We seek to pay consistent cash dividends to stockholders and create opportunities to increase dividend payments to stockholders as a result of annual increases in NOI and portfolio growth. To meet these objectives, we invest across the full spectrum of seniors housing and health care real estate and diversify our investment portfolio by property type, relationship and geographic location.

Substantially all of our revenues are derived from operating lease rentals, resident fees and services, interest earned on outstanding loans receivable and interest earned on short-term deposits. These items represent our primary sources of liquidity to fund distributions and depend upon the continued ability of our obligors to make contractual rent and interest payments to us and the profitability of our operating properties. To the extent that our obligors/partners experience operating difficulties and become unable to generate sufficient cash to make payments or operating distributions to us, there could be a material adverse impact on our consolidated results of operations, liquidity and/or financial condition. To mitigate this risk, we monitor our investments through a variety of methods determined by the type of property. Our asset management process for seniors

51

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

housing properties generally includes review of monthly financial statements and other operating data for each property, review of obligor/partner creditworthiness, property inspections and review of covenant compliance relating to licensure, real estate taxes, letters of credit and other collateral. Our internal property management division manages and monitors the outpatient medical portfolio with a comprehensive process including review of tenant relations, lease expirations, the mix of health service providers, hospital/health system relationships, property performance, capital improvement needs and market conditions among other things. We evaluate the operating environment in each property’s market to determine the likely trend in operating performance of the facility. When we identify unacceptable trends, we seek to mitigate, eliminate or transfer the risk. Through these efforts, we generally aim to intervene at an early stage to address any negative trends, and in so doing, support both the collectability of revenue and the value of our investment.

In addition to our asset management and research efforts, we aim to structure our relevant investments to mitigate payment risk. Operating leases and loans are normally credit enhanced by guarantees and/or letters of credit. Also, operating leases are typically structured as master leases and loans are generally cross-defaulted and cross-collateralized with other real estate loans, operating leases or agreements between us and the obligor and its affiliates.

For the year ended December 31, 2023, resident fees and services and rental income represented 72% and 23%, respectively, of total revenues. Substantially all of our operating leases are designed with escalating rent structures. Leases with fixed annual rental escalators are generally recognized on a straight-line basis over the initial lease period, subject to a collectability assessment. Rental income related to leases with contingent rental escalators is generally recorded based on the contractual cash rental payments due for the period. Our yield on loans receivable depends upon a number of factors, including the stated interest rate, the average principal amount outstanding during the term of the loan and any interest rate adjustments.

Our primary sources of cash include resident fees and services, rent and interest receipts, interest earned on short-term deposits, borrowings under our unsecured revolving credit facility and commercial paper program, public issuances of debt and equity securities, proceeds from investment dispositions and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including acquisitions, capital expenditures, construction advances and transaction costs), loan advances, property operating expenses, general and administrative expenses and other expenses. Depending upon the availability and cost of external capital, we believe our liquidity is sufficient to fund these uses of cash.

We also continuously evaluate opportunities to finance future investments. New investments are generally funded from temporary borrowings under our unsecured revolving credit facility and commercial paper program, internally generated cash and the proceeds from investment dispositions. Our investments generate cash from NOI and principal payments on loans receivable. Permanent financing for future investments, which replaces funds drawn under our unsecured revolving credit facility and commercial paper program, has historically been provided through a combination of the issuance of public debt and equity securities and the incurrence or assumption of secured debt. Given general economic conditions in 2023, investments were generally funded proactively via issuances of common stock.

Depending upon market conditions, we believe that new investments will be available in the future with spreads over our cost of capital that will generate appropriate returns to our stockholders. It is also likely that investment dispositions may occur in the future. To the extent that investment dispositions exceed new investments, our revenues and cash flows from operations could be adversely affected. We expect to reinvest the proceeds from any investment dispositions in new investments. To the extent that new investment requirements exceed our available cash on-hand, we expect to borrow under our unsecured revolving credit facility and commercial paper program. At December 31, 2023, we had $1,993,646,000 of cash and cash equivalents, $82,437,000 of restricted cash and $4,000,000,000 of available borrowing capacity under our unsecured revolving credit facility.

Key Transactions

Capital  The following summarizes key capital transactions that occurred during the year ended December 31, 2023:

•In May 2023, we issued $1,035,000,000 aggregate principal amount of 2.75% exchangeable senior unsecured notes maturing May 15, 2028 unless earlier exchanged, purchased or redeemed.

•During the year ended December 31, 2023, we issued $385,115,000 of secured debt at a blended average interest rate of 5.13% and assumed $428,578,000 of secured debt at a blended average interest rate of 6.42%. We extinguished $687,780,000 of secured debt at a blended average interest rate of 6.21%.

•In August 2023, Welltower and Welltower OP entered into the ATM Program (as defined below) pursuant to which we may offer and sell up to $4,000,000,000 of common stock of Welltower from time to time. During the twelve months ended December 31, 2023, we sold 53,300,874 shares of common stock under our current and previous ATM Programs generating gross proceeds of approximately $4,313,007,000.

•In November 2023, we issued 20,125,000 shares of common stock generating gross proceeds of approximately $1,772,216,000.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Investments

Investments The following summarizes our property acquisitions and joint venture investments completed during the year ended December 31, 2023 (dollars in thousands):

PropertiesBook Amount(1)Capitalization Rates(2)
Seniors Housing Operating52$2,655,9135.4%
Triple-net661,097,0049.4%
Outpatient Medical35474,0586.9%
Totals153$4,226,9756.6%

(1) Represents amounts recorded in net real estate investments including fair value adjustments pursuant to U.S. GAAP. See Note 3 to our consolidated financial statements for additional information.

(2) Represents annualized contractual or projected NOI to be received in cash divided by investment amounts.

Dispositions The following summarizes property dispositions completed during the year ended December 31, 2023 (dollars in thousands):

PropertiesProceeds(1)Book Amount(2)Capitalization Rates(3)
Seniors Housing Operating23$453,983$385,1282.1%
Triple-net26,9546,3915.0%
Totals25$460,937$391,5192.1%

(1) Represents pro rata proceeds received upon disposition including non-cash consideration.

(2) Represents carrying value of net real estate assets at time of disposition. See Note 5 to our consolidated financial statements for additional information.

(3) Represents annualized contractual income that was being received in cash at date of disposition divided by stated purchase price. Excludes properties sold that were recent development conversions.

Strategic Dissolution of Revera Joint Ventures During 2023, we entered into definitive agreements to dissolve our existing Revera joint venture relationships across the U.S., U.K. and Canada. The transactions include acquiring the remaining interests in 110 properties from Revera while simultaneously selling interest in 31 properties to Revera. See Note 5 to our consolidated financial statement for further information regarding the transaction.

Dividends Our Board of Directors declared a cash dividend for the quarter ended December 31, 2023 of $0.61 per share. On March 7, 2024, we will pay our 211th consecutive quarterly cash dividend to stockholders of record on February 23, 2024.

Key Performance Indicators, Trends and Uncertainties

We utilize several key performance indicators to evaluate the various aspects of our business. These indicators are discussed below and relate to operating performance, credit strength and concentration risk. Management uses these key performance indicators to facilitate internal and external comparisons to our historical operating results, in making operating decisions, and for budget planning purposes.

Operating Performance We believe that net income and net income attributable to common stockholders (“NICS”) per the Consolidated Statements of Comprehensive Income are the most appropriate earnings measures. Other useful supplemental measures of our operating performance include funds from operations attributable to common stockholders (“FFO”) and consolidated net operating income (“NOI”); however, these supplemental measures are not defined by U.S. GAAP. Please refer to the section entitled “Non-GAAP Financial Measures” for further discussion and reconciliations. These earnings measures are widely used by investors and analysts in the valuation, comparison and investment recommendations of companies.

The following table reflects the recent historical trends of our operating performance measures for the periods presented (in thousands):

Year Ended December 31,
202320222021
Net income$358,139$160,568$374,479
Net income attributable to common stockholders340,094141,214336,138
Funds from operations attributable to common stockholders1,763,2271,478,0721,220,722
Consolidated net operating income2,690,2192,301,8451,967,553

Credit Strength We measure our credit strength both in terms of leverage ratios and coverage ratios. The leverage ratios indicate how much of our balance sheet capitalization is related to long-term debt, net of cash and restricted cash. The coverage ratios indicate our ability to service interest and fixed charges (interest and secured debt principal amortization). We expect to maintain capitalization ratios and coverage ratios sufficient to maintain a capital structure consistent with our current profile.

53

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The coverage ratios are based on earnings before interest, taxes, depreciation and amortization ("EBITDA") and adjusted earnings before interest, taxes, depreciation and amortization (“Adjusted EBITDA”). Please refer to the section entitled “Non-GAAP Financial Measures” for further discussion and reconciliation of these measures. Leverage ratios and coverage ratios are widely used by investors, analysts and rating agencies in the valuation, comparison, investment recommendations and rating of companies. The following table reflects the recent historical trends for our credit strength measures for the periods presented:

Year Ended December 31,
202320222021
Net debt to book capitalization ratio34.3%39.5%42.2%
Net debt to undepreciated book capitalization ratio27.8%32.1%34.9%
Net debt to market capitalization ratio20.9%29.5%25.9%
Interest coverage ratio3.74x3.73x3.89x
Fixed charge coverage ratio3.44x3.37x3.43x
Adjusted interest coverage ratio3.95x3.94x3.89x
Adjusted fixed charge coverage ratio3.64x3.56x3.43x

Concentration Risk We evaluate our concentration risk in terms of NOI by property mix, relationship mix and geographic mix. Concentration risk is a valuable measure in understanding what portion of our NOI could be at risk if certain sectors were to experience downturns. Property mix measures the portion of our NOI that relates to our various property types. Relationship mix measures the portion of our NOI that relates to our current top five relationships. Geographic mix measures the portion of our NOI that relates to our current top five states (or international countries).

The following table reflects our recent historical trends of concentration risk by NOI for the years indicated below:

Year Ended December 31,(1)
202320222021
Property mix:
Seniors Housing Operating42%41%35%
Triple-net38%38%43%
Outpatient Medical20%21%22%
Relationship mix:
Integra Healthcare Properties8%—%—%
Sunrise Senior Living6%7%10%
Cogir Management Corporation4%3%2%
Avery Healthcare4%3%4%
Oakmont Management Group4%2%1%
Remaining74%85%83%
Geographic mix:
California12%14%13%
United Kingdom9%10%13%
Texas8%8%8%
Canada6%6%6%
Florida6%6%4%
Remaining59%56%56%

(1) Excludes our share of investments in unconsolidated entities and non-segment/corporate NOI. Entities in which we have a joint venture with a minority partner are shown at 100% of the joint venture amount.

We evaluate our key performance indicators in conjunction with current expectations to determine if historical trends are indicative of future results. Our expected results may not be achieved and actual results may differ materially from our expectations. Factors that may cause actual results to differ from expected results are described in more detail in “Item 1 — Business — Cautionary Statement Regarding Forward-Looking Statements” and “Item 1A — Risk Factors” and other sections of this Annual Report on Form 10-K. Management regularly monitors economic and other factors to develop strategic and tactical plans designed to improve performance and maximize our competitive position. Our ability to achieve our financial objectives is dependent upon our ability to effectively execute these plans and to appropriately respond to emerging economic and company-specific trends. Please refer to “Item 1 — Business,” “Item 1A — Risk Factors” in this Annual Report on Form 10-K for further discussion of these risk factors.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Corporate Governance

Maintaining investor confidence and trust is important in today’s business environment. Our Board of Directors and management are strongly committed to policies and procedures that reflect the highest level of ethical business practices. Our corporate governance guidelines provide the framework for our business operations and emphasize our commitment to increase stockholder value while meeting all applicable legal requirements. These guidelines meet the listing standards adopted by the New York Stock Exchange and are available on the Internet at www.welltower.com/investors/governance. The information on our website is not incorporated by reference in this Annual Report on Form 10-K, and our web address is included as an inactive textual reference only.

Liquidity and Capital Resources

Sources and Uses of Cash

Our primary sources of cash include resident fees and services, rent and interest receipts, interest earned on short-term deposits, borrowings under our unsecured revolving credit facility and commercial paper program, public issuances of debt and equity securities, proceeds from investment dispositions and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including acquisitions, capital expenditures, construction advances and transaction costs), loan advances, property operating expenses, general and administrative expenses and other expenses. Depending upon the availability and cost of external capital, we believe our liquidity is sufficient to fund these uses of cash. These sources and uses of cash are reflected in our Consolidated Statements of Cash Flows and are discussed in further detail below. The following is a summary of our sources and uses of cash flows for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20232022$%2021$%$%
Cash, cash equivalents and restricted cash at beginning of period$722,292$346,755$375,537108%$2,021,043$(1,674,288)-83%$(1,298,751)-64%
Net cash provided from (used in):
Operating activities1,601,8611,328,708273,15321%1,275,32553,3834%326,53626%
Investing activities(5,707,742)(3,703,815)(2,003,927)54%(4,516,268)812,453-18%(1,191,474)26%
Financing activities5,448,6472,761,2772,687,37097%1,567,6641,193,61376%3,880,983248%
Effect of foreign currency translation11,025(10,633)21,658n/a(1,009)(9,624)954%12,034n/a
Cash, cash equivalents and restricted cash at end of period$2,076,083$722,292$1,353,791187%$346,755$375,537108%$1,729,328499%

Operating Activities Please see “Results of Operations” for discussion of net income fluctuations. For the years ended December 31, 2023, 2022 and 2021, cash flows provided from operations exceeded cash distributions to stockholders.

Investing Activities  The changes in net cash provided from/used in investing activities are primarily attributable to net changes in real property investments and dispositions, loans receivable and investments in unconsolidated entities, which are summarized above in “Key Transactions.” Please refer to Notes 3 and 5 of our consolidated financial statements for additional information. The following is a summary of cash used in non-acquisition capital improvement activities for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20232022$%2021$%$%
New development$1,014,935$631,737$383,19861%$417,963$213,77451%$596,972143%
Recurring capital expenditures, tenant improvements and lease commissions199,359198,576783%99,99498,58299%99,36599%
Renovations, redevelopments and other capital improvements318,323277,44040,88315%182,59494,84652%135,72974%
Total$1,532,617$1,107,753$424,86438%$700,551$407,20258%$832,066119%

The change in new development is primarily due to the number and size of construction projects on-going during the relevant periods. Renovations, redevelopments and other capital improvements include expenditures to maximize property value, increase net operating income, maintain a market-competitive position and/or achieve property stabilization. The increase in overall development and recurring capital expenditures, tenant improvements and lease commissions is due primarily to portfolio growth and increased spending after a contraction during the pandemic.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Financing Activities The changes in net cash provided from/used in financing activities are primarily attributable to changes related to our long-term debt arrangements, the issuances of common stock and dividend payments which are summarized above in “Key Transactions.” Please refer to Notes 10, 11 and 14 to our consolidated financial statements for additional information.

In April 2022, we closed on an amended $5,200,000,000 unsecured credit facility, increasing our term loan capacity by $500,000,000. In May 2023, we issued $1,035,000,000 aggregate principal amount of 2.75% exchangeable senior unsecured notes maturing May 15, 2028. During the twelve months ended December 31, 2023, we issued $385,115,000 of secured debt at a blended average interest rate of 5.13% and assumed $428,578,000 of secured debt at a blended average interest rate of 6.42%. As of December 31, 2023, we have total near-term available liquidity of approximately $6.1 billion.

Off-Balance Sheet Arrangements

At December 31, 2023, we had investments in unconsolidated entities with our ownership generally ranging from 10% to 95%. We use financial derivative instruments to hedge interest rate and foreign currency exchange rate exposure. At December 31, 2023, we had 23 outstanding letter of credit obligations. Please see Notes 8, 12 and 13 to our consolidated financial statements for additional information.

Contractual Obligations

The following table summarizes our payment requirements under contractual obligations as of December 31, 2023 (in thousands):

Payments Due by Period
Contractual ObligationsTotal20242025-20262027-2028Thereafter
Senior unsecured notes and term credit facilities:(1)
U.S. Dollar senior unsecured notes$10,935,000$1,350,000$1,950,000$2,285,000$5,350,000
Canadian Dollar senior unsecured notes(2)227,239227,239
Pounds Sterling senior unsecured notes(2)1,338,015700,865637,150
U.S. Dollar term credit facility1,010,00010,0001,000,000
Canadian Dollar term credit facility(2)189,365189,365
Secured debt:(1,2)
Consolidated2,222,445400,258584,321317,637920,229
Unconsolidated1,111,216229,175557,721139,840184,480
Contractual interest obligations:(3)
Senior unsecured notes and term loans(2)3,741,633528,777908,731673,2481,630,877
Consolidated secured debt(2)454,51399,336123,87395,763135,541
Unconsolidated secured debt(2)124,59738,00330,96514,19941,430
Finance lease liabilities(4)391,3885,5478,0107,939369,892
Operating lease liabilities(4)951,39819,32935,43732,785863,847
Purchase obligations(5)2,171,3041,923,419244,7942,561530
Total contractual obligations$24,868,113$4,593,844$4,453,852$5,686,441$10,133,976

(1) Amounts represent principal amounts due and do not reflect unamortized premiums/discounts or other fair value adjustments as reflected on the Consolidated Balance Sheets.

(2) Based on foreign currency exchange rates in effect as of balance sheet date.

(3) Based on variable interest rates in effect as of December 31, 2023.

(4) See Note 6 to our consolidated financial statements for additional information.

(5) See Note 13 to our consolidated financial statements for additional information.

Capital Structure

Please refer to “Credit Strength” above for a discussion of our leverage and coverage ratio trends. Our debt agreements contain various covenants, restrictions and events of default. Certain agreements require us to maintain financial ratios and minimum net worth and impose certain limits on our ability to incur indebtedness, create liens and make investments or acquisitions. As of December 31, 2023, we were in compliance in all material respects with the covenants under our debt agreements. None of our debt agreements contain provisions for acceleration which could be triggered by our debt ratings. However, under our primary unsecured credit facility, the ratings on our senior unsecured notes are used to determine the fees and interest charged. We plan to manage the company to maintain compliance with our debt covenants and with a capital structure consistent with our current profile. Any downgrades in terms of ratings or outlook by any or all of the rating agencies could have a material adverse impact on our cost and availability of capital, which could have a material adverse impact on our consolidated results of operations, liquidity and/or financial condition.

56

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

On April 1, 2022, Welltower and Welltower OP jointly filed with the Securities and Exchange Commission (the “SEC”) an open-ended automatic or “universal” shelf registration statement on Form S-3 (the "Shelf Form S-3") covering an indeterminate amount of future offerings of Welltower’s debt securities, common stock, preferred stock, depositary shares, guarantees of debt securities issued by Welltower OP, warrants and units and Welltower OP’s debt securities and guarantees of debt securities issued by Welltower to replace Old Welltower’s existing “universal” shelf registration statement filed with the SEC on May 4, 2021. On April 1, 2022, Welltower also filed with the SEC a registration statement in connection with its enhanced dividend reinvestment plan (“DRIP”) under which it may issue up to 15,000,000 shares of common stock to replace Old Welltower’s existing DRIP registration statement on Form S-3 filed with the SEC on May 4, 2021. On May 3, 2023, Welltower and Welltower OP filed post-effective amendment no. 1 to the Shelf Form S-3 pursuant to which Welltower OP expressly adopted the Shelf Form S-3 as its own registration statement following its statutory conversion from a corporation to a limited liability company. As of February 9, 2024, 15,000,000 shares of common stock remained available for issuance under the DRIP registration statement. On August 1, 2023, Welltower and Welltower OP entered into an equity distribution agreement (the “EDA”) with (i) Barclays Capital Inc., BMO Capital Markets Corp., BNP Paribas Securities Corp., BNY Mellon Capital Markets, LLC, BofA Securities, Inc., BOK Financial Securities, Inc., Capital One Securities Inc., Citigroup Global Markets Inc., Citizens JMP Securities, LLC, Comerica Securities, Inc., Credit Agricole Securities (USA) Inc., Deutsche Bank Securities Inc., Fifth Third Securities, Inc., Goldman Sachs & Co. LLC, Jefferies LLC, J.P. Morgan Securities LLC, KeyBanc Capital Markets Inc., Loop Capital Markets LLC, Mizuho Securities USA LLC, Morgan Stanley & Co. LLC, MUFG Securities Americas Inc., RBC Capital Markets, LLC, Regions Securities LLC, Robert W. Baird & Co. Incorporated, Scotia Capital (USA) Inc., Synovus Securities, Inc., TD Securities (USA) LLC, Truist Securities, Inc. and Wells Fargo Securities, LLC as sales agents and forward sellers and (ii) the forward purchasers named therein relating to issuances, offers and sales from time to time of up to $4,000,000,000 aggregate amount of common stock of Welltower (together with the existing master forward sale confirmations relating thereto, the “ATM Program”). The ATM Program also allows Welltower to enter into forward sale agreements. As of February 9, 2024, we had $1,451,479,501 of remaining capacity under the ATM Program and there were no outstanding forward sales agreements. Depending upon market conditions, we anticipate issuing securities under our registration statements to invest in additional properties and to repay borrowings under our unsecured revolving credit facility and commercial paper program.

In connection with the filing of the Shelf Form S-3, Welltower also filed with the SEC a prospectus supplement that will continue an offering that was previously covered by Old Welltower's prospectus supplement and the accompanying prospectus to the prior registration statement relating to the registration of up to 475,327 shares of common stock of Welltower Inc. (the “DownREIT II Shares”) that may be issued from time to time if, and to the extent that, certain holders of Class A units (the “DownREIT II Units”) of HCN G&L DownREIT II LLC, a Delaware limited liability company (the “DownREIT II”), tender such DownREIT II Units for redemption by the DownREIT II, and HCN DownREIT Member, LLC, a majority-owned indirect subsidiary of Welltower (including its permitted successors and assigns, the “Managing Member”), or a designated affiliate of the Managing Member, elects to assume the redemption obligations of the DownREIT II and to satisfy all or a portion of the redemption consideration by issuing DownREIT II Shares to the holders instead of or in addition to paying a cash amount. On July 22, 2022, Welltower filed with the SEC a prospectus supplement relating to the registration of up to 300,026 shares of common stock of Welltower Inc. that may be issued from time to time if, and to the extent that, certain holders of Class A Common Units (the "OP Units") of Welltower OP tender the OP Units for redemption by Welltower OP, and Welltower Inc. elects to assume the redemption obligations of Welltower OP and to satisfy all or a portion of the redemption consideration by issuing shares of its common stock to the holders instead of or in addition to paying a cash amount. On August 9, 2023, Welltower filed with the SEC a prospectus supplement relating to the registration of up to 13,559,535 shares of common stock of Welltower Inc. (the "Exchanged Shares") that may, under certain circumstances, be issuable upon exchange of 2.750% exchangeable senior notes due 2028 of Welltower OP and the resale from time to time by the recipients of the Exchanged Shares.

Supplemental Guarantor Information

Welltower OP has issued the unsecured notes described in Note 11 to our Consolidated Financial Statements. All unsecured notes are fully and unconditionally guaranteed by Welltower, and Welltower OP is 99.765% owned by Welltower as of December 31, 2023. Effective January 4, 2021, the SEC adopted amendments to the financial disclosure requirements applicable to registered debt offerings that include certain credit enhancements. We have adopted these new rules, which permits subsidiary issuers of obligations guaranteed by the parent to omit separate financial statements if the consolidated financial statements of the parent company have been filed, the subsidiary obligor is a consolidated subsidiary of the parent company, the guaranteed security is debt or debt-like, and the security is guaranteed fully and unconditionally by the parent. Accordingly, separate consolidated financial statements of Welltower OP have not been presented. Furthermore, Welltower and Welltower OP have no material assets, liabilities, or operations other than financing activities and their investments in non-guarantor subsidiaries. Therefore, we meet the criteria in Rule 13-01 of Regulation S-X to omit the summarized financial information from our disclosures.

57

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Results of Operations

Summary

Our primary sources of revenue include resident fees and services, rent, interest income and interest earned on short-term deposits. Our primary expenses include property operating expenses, depreciation and amortization, interest expense, general and administrative expenses, and other expenses. We evaluate our business and make resource allocations on our three business segments: Seniors Housing Operating, Triple-net and Outpatient Medical. The primary performance measures for our properties are NOI and same store NOI ("SSNOI") and other supplemental measures include FFO and Adjusted EBITDA, which are further discussed below. Please see Non-GAAP Financial Measures for additional information and reconciliations related to these supplemental measures.

This section of this Form 10-K generally discusses 2023 and 2022 items and year-to-year comparisons between 2023 and 2022. Discussions of 2021 items and year-to-year comparisons between 2022 and 2021 that are not included in this Form 10-K can be found in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 of the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022.

The following is a summary of our results of operations for the periods presented (dollars in thousands, except per share amounts):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20232022Amount%2021Amount%Amount%
Net income$358,139$160,568$197,571123%$374,479$(213,911)-57%$(16,340)-4%
NICS340,094141,214198,880141%336,138(194,924)-58%3,9561%
FFO1,763,2271,478,072285,15519%1,220,722257,35021%542,50544%
EBITDA2,373,4502,007,702365,74818%1,910,61197,0915%462,83924%
Adjusted EBITDA2,509,0032,122,399386,60418%1,913,546208,85311%595,45731%
NOI2,690,2192,301,845388,37417%1,967,553334,29217%722,66637%
Per share data (fully diluted):
Net income attributable to common stockholders (1)$0.66$0.30$0.36120%$0.78$(0.48)-62%$(0.12)-15%
Funds from operations attributable to common stockholders$3.40$3.18$0.227%$2.86$0.3211%$0.5419%
Interest coverage ratio3.74x3.73x0.01x%3.89x-0.16x-4%-0.15x-4%
Fixed charge coverage ratio3.44x3.37x0.07x2%3.43x-0.06x-2%0.01x%
Adjusted interest coverage ratio3.95x3.94x0.01x%3.89x0.05x1%0.06x2%
Adjusted fixed charge coverage ratio3.64x3.56x0.08x2%3.43x0.13x4%0.21x6%
(1) Includes adjustment to the numerator for income (loss) attributable to OP unitholders.

The following table represents the changes in outstanding common stock for the period from January 1, 2021 to December 31, 2023 (in thousands):

Year Ended December 31,
December 31, 2023December 31, 2022December 31, 2021Totals
Beginning balance490,508447,239417,401417,401
Redemption of OP Units and DownREIT Units3365341
Option exercises426
ATM Program issuances53,30143,09329,667126,061
Equity issuances20,12520,125
Other, net(33)169171307
Ending balance564,241490,508447,239564,241
Weighted average number of shares outstanding:
Basic515,629462,185424,976
Diluted518,701465,158426,841

A portion of our earnings are derived primarily from long-term investments with predictable rates of return. These investments are mainly financed with a combination of equity, senior unsecured notes, secured debt and borrowings under our primary unsecured credit facility. During inflationary periods, which generally are accompanied by rising interest rates, our ability to grow may be adversely affected because the yield on new investments may increase at a slower rate than new borrowing costs.

58

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Seniors Housing Operating

The following is a summary of our results of operations for the Seniors Housing Operating segment for the years presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20232022$%2021$%$%
Revenues:
Resident fees and services$4,753,804$4,173,711$580,09314%$3,197,223$976,48831%$1,556,58149%
Interest income10,0967,8672,22928%4,2313,63686%5,865139%
Other income9,74363,839(54,096)-85%11,79652,043441%(2,053)-17%
Total revenues4,773,6434,245,417528,22612%3,213,2501,032,16732%1,560,39349%
Property operating expenses3,655,5083,292,045363,46311%2,529,344762,70130%1,126,16445%
NOI(1)1,118,135953,372164,76317%683,906269,46639%434,22963%
Other expenses:
Depreciation and amortization906,771854,80051,9716%593,565261,23544%313,20653%
Interest expense56,50934,83321,67662%39,327(4,494)-11%17,18244%
Loss (gain) on extinguishment of debt, net386(386)-100%(2,628)3,014115%2,628100%
Provision for loan losses, net3,1971,0392,158208%394645164%2,803711%
Impairment of assets24,99913,14611,85390%22,317(9,171)-41%2,68212%
Other expenses96,97266,02630,94647%27,13238,894143%69,840257%
1,088,448970,230118,21812%680,107290,12343%408,34160%
Income (loss) from continuing operations before income taxes and other items29,687(16,858)46,545276%3,799(20,657)-544%25,888681%
Income (loss) from unconsolidated entities(69,835)(53,318)(16,517)-31%(39,225)(14,093)-36%(30,610)-78%
Gain (loss) on real estate dispositions, net68,2905,79462,496n/a6,146(352)-6%62,144n/a
Income (loss) from continuing operations28,142(64,382)92,524144%(29,280)(35,102)-120%57,422196%
Net income (loss)28,142(64,382)92,524144%(29,280)(35,102)-120%57,422196%
Less: Net income (loss) attributable to noncontrolling interests(6,391)(16,258)9,86761%(2,224)(14,034)-631%(4,167)-187%
Net income (loss) attributable to common stockholders$34,533$(48,124)$82,657172%$(27,056)$(21,068)-78%$61,589228%

(1) See Non-GAAP Financial Measures below.

Resident fees and services and property operating expenses for the year ended December 31, 2023 increased compared to the prior year primarily due to acquisitions outpacing dispositions. Additionally, our Seniors Housing Operating revenues are dependent on occupancy and rate growth, both of which have continued to steadily increase during 2023. Average occupancy is as follows:

Three Months Ended(1)
March 31,June 30,September 30,December 31,
202276.3%77.1%78.0%78.3%
202379.0%79.6%80.7%82.2%

(1) Average occupancy includes our minority ownership share related to unconsolidated properties and excludes the minority partners' noncontrolling ownership share related to consolidated properties. Also excludes land parcels and properties under development.

Effective on April 1, 2022, our leasehold interest relating to the master lease with National Health Investors, Inc. ("NHI") for 17 properties assumed in conjunction with the Holiday Retirement acquisition was terminated as a result of the transition or sale of the properties by NHI. The lease termination was part of an agreement to resolve outstanding litigation with NHI. In conjunction with the agreement, a wholly owned subsidiary and the lessee on the master lease agreed to release $6,883,000 of cash to the landlord, which represents the net cash flow generated from the properties since we assumed the leasehold interest. Additionally, in connection with the lease termination, during the year ended December 31, 2022 we recognized $58,621,000 in other income on our Consolidated Statements of Comprehensive Income, from the derecognition of the right of use asset and related lease liability.

We received government grants under the CARES Act primarily to cover increased expenses and lost revenue during the COVID-19 pandemic, as well as under similar programs in the U.K. and Canada. We recognized $21,220,000 and $38,607,000 during the years ended December 31, 2023 and 2022, respectively. These grants represent a reduction to property operating expenses in our Consolidated Statements of Comprehensive Income.

59

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a summary of our SSNOI at Welltower's share for the Seniors Housing Operating segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2023December 31, 2022$%December 31, 2023December 31, 2022$%
SSNOI(1)$236,993$193,149$43,84422.7%$788,605$654,320$134,28520.5%

(1) Relates to 647 properties for the QTD Pool and 556 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

During the year ended December 31, 2023, we recorded impairment charges of $14,315,000 related to four held for sale properties for which the carrying value exceeded the estimated fair value less costs to sell and $10,684,000 related to three held for use properties for which the carrying value exceeded the estimated fair value. During the year ended December 31, 2022, we recorded impairment charges of $13,146,000 related to one held for sale property. Transaction costs related to asset acquisitions are capitalized as a component of the purchase price. The fluctuation in other expenses is primarily due to the timing of noncapitalizable transaction costs associated with acquisitions and operator transitions. Changes in the gain on sales of properties are related to the volume and timing of property sales and the sales prices.

Depreciation and amortization fluctuates as a result of acquisitions, disposition and transitions. To the extent we acquire or dispose of additional properties in the future, our provision for depreciation and amortization will change accordingly.

During the year ended December 31, 2023, we completed ten Seniors Housing Operating construction conversions representing $463,644,000 or $306,846 per unit. The following is a summary of our consolidated Seniors Housing Operating construction projects in process, excluding expansions (dollars in thousands):

As of December 31, 2023
Expected Conversion Year(1)PropertiesUnits/BedsAnticipated Remaining FundingConstruction in Progress Balance
2024213,389$296,186$756,968
202561,423299,647175,867
TBD(2)1092,752
Total37$1,025,587
(1) Properties expected to be converted in phases over multiple years are reflected in the last expected year.
(2) Represents projects for which a final budget or expected conversion date are not yet known.

Interest expense represents secured debt interest expense, which fluctuates based on the net effect and timing of assumptions, segment transitions, fluctuations in foreign currency rates, extinguishments and principal amortizations. The fluctuations in loss (gain) on extinguishment of debt is primarily attributable to the volume of extinguishments and terms of the related secured debt.

The following is a summary of our Seniors Housing Operating segment property secured debt principal activity (dollars in thousands):

Year Ended December 31,
202320222021
Beginning balance$1,701,939$1,599,522$1,706,189
Debt transferred in32,478
Debt issued385,115113,18323,569
Debt assumed381,837288,522
Debt extinguished(486,825)(227,910)(77,959)
Principal payments(47,672)(47,399)(50,603)
Foreign currency20,654(56,457)(1,674)
Ending balance$1,955,048$1,701,939$1,599,522
Ending weighted average interest4.68%4.32%2.81%

The majority of our Seniors Housing Operating properties are formed through partnership interests. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. Income from unconsolidated entities during the year ended December 31, 2023 includes other than temporary impairment charges of $35,293,000, primarily related to unconsolidated management companies. Net income attributable to noncontrolling interests represents our partners’ share of net income (loss) related to joint ventures.

60

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Triple-net

The following is a summary of our results of operations for the Triple-net segment for the years presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20232022$%2021$%$%
Revenues:
Rental income$814,751$782,329$32,4224%$761,441$20,8883%$53,3107%
Interest income157,592142,40215,19011%124,54017,86214%33,05227%
Other income70,9866,77664,210948%4,6032,17347%66,383n/a
Total revenues1,043,329931,507111,82212%890,58440,9235%152,74517%
Property operating expenses42,19444,483(2,289)-5%49,462(4,979)-10%(7,268)-15%
NOI(1)1,001,135887,024114,11113%841,12245,9025%160,01319%
Other expenses:
Depreciation and amortization231,028215,88715,1417%220,699(4,812)-2%10,3295%
Interest expense(65)963(1,028)-107%6,376(5,413)-85%(6,441)-101%
Loss (gain) on derivatives and financial instruments, net(2,120)8,334(10,454)-125%(7,333)15,667214%5,21371%
Loss (gain) on extinguishment of debt, net80(80)-100%80n/an/a
Provision for loan losses, net6,3489,289(2,941)-32%10,339(1,050)-10%(3,991)-39%
Impairment of assets11,0983,5957,503209%26,579(22,984)-86%(15,481)-58%
Other expenses5,06013,043(7,983)-61%4,1898,854211%87121%
251,349251,191158%260,849(9,658)-4%(9,500)-4%
Income (loss) from continuing operations before income taxes and other items749,786635,833113,95318%580,27355,56010%169,51329%
Income (loss) from unconsolidated entities16,70034,495(17,795)-52%20,68713,80867%(3,987)-19%
Gain (loss) on real estate dispositions, net25916,648(16,389)-98%135,881(119,233)-88%(135,622)-100%
Income (loss) from continuing operations766,745686,97679,76912%736,841(49,865)-7%29,9044%
Net income (loss)766,745686,97679,76912%736,841(49,865)-7%29,9044%
Less: Net income (loss) attributable to noncontrolling interests23,69828,958(5,260)-18%35,653(6,695)-19%(11,955)-34%
Net income (loss) attributable to common stockholders$743,047$658,018$85,02913%$701,188$(43,170)-6%$41,8596%

(1) See Non-GAAP Financial Measures below.

Rental income has increased primarily due to acquisitions and annual rent increases. Certain of our leases contain annual rental escalators that are contingent upon changes in the Consumer Price Index and/or changes in the gross operating revenues of the tenant’s properties. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. If gross operating revenues at our facilities and/or the Consumer Price Index do not increase, a portion of our revenues may not continue to increase. For the year ended December 31, 2023, we had 87 leases with rental rate increases ranging from 0.58% to 549.38% in our Triple-net portfolio.

These increases are partially offset by the write off of straight-line rent receivable balances of $16,642,000 during the year ended December 31, 2023, which relate to leases for which the collection of substantially all contractual lease payments was no longer deemed probable.

The increase in interest income during the year ended December 31, 2023 is primarily driven by increased advances on loans receivable during the year.

As part of the substantial exit of the Genesis HealthCare operating relationship, which we disclosed on March 2, 2021, we transitioned the sublease of a portfolio of seven facilities from Genesis HealthCare to Complete Care Management in the second quarter of 2021. As part of the March 2021 transaction, we entered into a forward sale agreement for the seven properties valued at $182,618,000, which was expected to close when the Welltower-held purchase option became exercisable. As of March 31, 2023, the right of use assets related to the properties were $115,359,000 and were reflected as held for sale with the corresponding lease liabilities of $66,530,000 on our Consolidated Balance Sheet. On May 1, 2023, we executed a series of transactions that included the assignment of the leasehold interest to a newly formed tri-party unconsolidated joint venture with Aurora Health Network, Peace Capital (an affiliate of Complete Care Management) and us, and culminated with the closing of the purchase option by the joint venture. The transactions resulted in net cash proceeds to us of $104,240,000 after our retained interest of $11,571,000 in the joint venture and a gain from the loss of control and derecognition of the leasehold interest of $65,485,000, which we recorded in other income within our Consolidated Statements of Comprehensive Income during the year ended December 31, 2023.

61

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a summary of our SSNOI at Welltower's share for the Triple-net segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2023December 31, 2022$%December 31, 2023December 31, 2022$%
SSNOI(1)$110,219$107,627$2,5922.4%$436,238$426,557$9,6812.3%

(1) Relates to 364 properties for the QTD Pool and 364 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

Depreciation and amortization fluctuates as a result of the acquisitions, dispositions and segment transitions of Triple-net properties. To the extent we acquire or dispose of additional properties in the future, our provision for depreciation and amortization will change accordingly.

During the year ended December 31, 2023, we recorded impairment charges of $1,086,000 for one held for sale property for which the carrying value exceeded the estimated fair value less costs to sell and $10,012,000 related to two held for use properties for which the carrying value exceeded the estimated fair value. During the year ended December 31, 2022, we recorded impairment charges of $3,595,000 related to two held for use properties. Transaction costs related to asset acquisitions are capitalized as a component of purchase price. The fluctuation in other expenses is primarily due to noncapitalizable transaction costs from acquisitions and segment transitions. Changes in the gain on sales of properties are related to the volume and timing of property sales and the sales prices.

During the year ended December 31, 2023, there was one Triple-net construction project completed representing $141,142,000 or $738,963 per unit.

Interest expense represents secured debt interest expense and related fees. The change in secured debt interest expense is due to the net effect and timing of assumptions, segment transitions, fluctuations in foreign currency rates, extinguishments and principal amortizations. The following is a summary of our Triple-net secured debt principal activity for the periods presented (dollars in thousands):

Year Ended December 31,
202320222021
Beginning balance$39,179$72,536$123,652
Debt assumed39,574
Debt extinguished(39,574)(46,402)
Debt transferred out(32,478)
Principal payments(919)(879)(4,679)
Foreign currency(35)
Ending balance$38,260$39,179$72,536
Ending weighted average interest4.39%4.39%4.57%

Loss (gain) on derivatives and financial instruments, net is primarily attributable to the mark-to-market of the equity warrants received as part of the HC-One transactions that closed in 2021 and 2023.

A portion of our Triple-net properties were formed through partnerships. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. The increase in income from unconsolidated entities during the year ended December 31, 2022 is primarily related to the write off of a right of use asset and related lease liability on an unconsolidated joint venture that was restructured during the year. Net income attributable to noncontrolling interests represents our partners’ share of net income relating to those partnerships where we are the controlling partner.

62

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Outpatient Medical

The following is a summary of our results of operations for the Outpatient Medical segment for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20232022$%2021$%$%
Revenues:
Rental income$741,322$669,457$71,86511%$613,254$56,2039%$128,06821%
Interest income666302364121%8,792(8,490)-97%(8,126)-92%
Other income9,1678,9981692%13,243(4,245)-32%(4,076)-31%
Total revenues751,155678,75772,39811%635,28943,4687%115,86618%
Property operating expenses231,956205,99725,95913%186,93919,05810%45,01724%
NOI(1)519,199472,76046,43910%448,35024,4105%70,84916%
Other expenses:
Depreciation and amortization263,302239,68123,62110%223,30216,3797%40,00018%
Interest expense10,54318,078(7,535)-42%17,5065723%(6,963)-40%
Loss (gain) on extinguishment of debt, net715(8)-53%(4)19475%11275%
Provision for loan losses, net264(8)272n/a(3,463)3,455100%3,727108%
Impairment of assets761(761)-100%2,211(1,450)-66%(2,211)-100%
Other expenses2,2892,537(248)-10%2,523141%(234)-9%
276,405261,06415,3416%242,07518,9898%34,33014%
Income (loss) from continuing operations before income taxes and other item242,794211,69631,09815%206,2755,4213%36,51918%
Income (loss) from unconsolidated entities(307)(2,467)2,16088%(4,395)1,92844%4,08893%
Gain (loss) on real estate dispositions, net(651)(6,399)5,74890%93,348(99,747)-107%(93,999)-101%
Income (loss) from continuing operations241,836202,83039,00619%295,228(92,398)-31%(53,392)-18%
Net income (loss)241,836202,83039,00619%295,228(92,398)-31%(53,392)-18%
Less: Net income (loss) attributable to noncontrolling interests1,9107,180(5,270)-73%4,9162,26446%(3,006)-61%
Net income (loss) attributable to common stockholders$239,926$195,650$44,27623%$290,312$(94,662)-33%$(50,386)-17%

(1) See Non-GAAP Financial Measures below.

Rental income has increased due primarily to acquisitions and construction conversions that occurred during 2022 and 2023. Certain of our leases contain annual rental escalators that are contingent upon changes in the Consumer Price Index. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. If the Consumer Price Index does not increase, a portion of our revenues may not continue to increase. Our leases could renew above or below current rental rates, resulting in an increase or decrease in rental income. For the year ended December 31, 2023, our consolidated Outpatient Medical portfolio signed 512,694 square feet of new leases and 2,255,492 square feet of renewals. The weighted-average term of these leases was seven years, with a rate of $37.52 per square foot and tenant improvement and lease commission costs of $28.00 per square foot. Substantially all of these leases contain an annual fixed or contingent escalation rent structure ranging from 1.0% to 28.0%.

The fluctuation in property operating expenses and depreciation and amortization are primarily attributable to acquisitions and construction conversions that occurred during 2022 and 2023. To the extent that we acquire or dispose of additional properties in the future, these amounts will change accordingly.

The following is a summary of our SSNOI at Welltower share for the Outpatient Medical segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2023December 31, 2022$%December 31, 2023December 31, 2022$%
SSNOI(1)$119,706$115,180$4,5263.9%$451,959$441,664$10,2952.3%

(1) Relates to 377 properties for the QTD Pool and 366 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

During the year ended December 31, 2023, no impairment charge was recorded. During the year ended December 31, 2022, we recognized an impairment charge of $761,000 related to one held for use property. Transaction costs related to asset acquisitions are capitalized as a component of purchase price. The fluctuation in other expenses is primarily due to noncapitalizable transaction costs. Changes in gains/losses on sales of properties are related to volume of property sales and the sales prices.

63

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

During the year ended December 31, 2023, we completed four Outpatient Medical construction conversions representing $190,770,000 or $582 per square foot. The following is a summary of our consolidated Outpatient Medical construction projects in process, excluding expansions (dollars in thousands):

As of December 31, 2023
Expected Conversion YearPropertiesSquare FeetAnticipated Remaining FundingConstruction in Progress Balance
202410788,925$277,333$174,476
20252149,29093,6637,249
TBD(1)133,369
Total13$215,094
(1) Represents projects for which a final budget or expected conversion date are not yet known.

Total interest expense represents secured debt interest expense. The change in secured debt interest expense is primarily due to the net effect and timing of assumptions, extinguishments and principal amortizations. The following is a summary of our Outpatient Medical secured debt principal activity (dollars in thousands):

Year Ended December 31,
202320222021
Beginning balance$388,836$530,254$548,229
Debt assumed46,741
Debt extinguished(200,955)(131,582)(7,670)
Principal payments(5,485)(9,836)(10,305)
Ending balance$229,137$388,836$530,254
Ending weighted average interest5.42%4.38%3.49%

A portion of our Outpatient Medical properties were formed through partnerships. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. Net income attributable to noncontrolling interests represents our partners’ share of net income or loss relating to those partnerships where we are the controlling partner.

Non-Segment/Corporate

The following is a summary of our results of operations for the Non-Segment/Corporate activities for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20232022$%2021$%$%
Revenues:
Other income$69,868$4,934$64,934n/a$2,992$1,94265%$66,876n/a
Total revenues69,8684,93464,934n/a2,9921,94265%66,876n/a
Property operating expenses18,11816,2451,87312%8,8177,42884%9,301105%
NOI(1)51,750(11,311)63,061558%(5,825)(5,486)-94%57,575988%
Other expenses:
Interest expense540,859475,64565,21414%426,64449,00111%114,21527%
General and administrative expenses179,091150,39028,70119%126,72723,66319%52,36441%
Loss (gain) on extinguishments of debt, net199(199)-100%52,506(52,307)-100%(52,506)-100%
Other expenses4,02020,064(16,044)-80%7,89512,169154%(3,875)-49%
Total expenses723,970646,29877,67212%613,77232,5265%110,19818%
Loss from continuing operations before income taxes and other items(672,220)(657,609)(14,611)-2%(619,597)(38,012)-6%(52,623)-8%
Income tax (expense) benefit(6,364)(7,247)88312%(8,713)1,46617%2,34927%
Loss from continuing operations(678,584)(664,856)(13,728)-2%(628,310)(36,546)-6%(50,274)-8%
Net income (loss)(678,584)(664,856)(13,728)-2%(628,310)(36,546)-6%(50,274)-8%
Less: Net income (loss) attributable to noncontrolling interests(1,172)(526)(646)-123%(4)(522)n/a(1,168)n/a
Net loss attributable to common stockholders$(677,412)$(664,330)$(13,082)-2%$(628,306)$(36,024)-6%$(49,106)-8%

(1) See Non-GAAP Financial Measures below.

64

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The increase in other income for the year ended December 31, 2023 is primarily due to interest earned on deposits. Property operating expenses represent insurance costs related to our captive insurance company, which acts as a direct insurer of property level insurance coverage for our portfolio.

The following is a summary of our Non-Segment/Corporate interest expense for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20232022$%2021$%$%
Senior unsecured notes$508,681$436,185$72,49617%$401,247$34,9389%$107,43427%
Unsecured credit facility and commercial paper program6,97719,576(12,599)-64%6,75912,817190%2183%
Loan expense25,20119,8845,31727%18,6381,2467%6,56335%
Totals$540,859$475,645$65,21414%$426,644$49,00111%$114,21527%

The change in interest expense on senior unsecured notes is due to the net effect of issuances and extinguishments, as well as the movement in foreign exchange rates and related hedge activity. Please refer to Note 11 to the consolidated financial statements for additional information. The change in interest expense on our unsecured revolving credit facility and commercial paper program is due primarily to the net effect and timing of draws, paydowns and variable interest rate changes. Please refer to Note 10 of our consolidated financial statements for additional information regarding our unsecured revolving credit facility and commercial paper program. Loan expenses represent the amortization of costs incurred in connection with senior unsecured notes issuances.

General and administrative expenses as a percentage of consolidated revenues for the years ended December 31, 2023, 2022 and 2021 were 2.70%, 2.57% and 2.67%, respectively. The increase during the year ended December 31, 2023 is primarily driven by compensation costs associated with increased employee headcount. Other expenses includes non-capitalizable legal expenses, including related to our umbrella partnership REIT reorganization during 2022. The provision for income taxes primarily relates to state taxes, foreign taxes and taxes based on income generated by entities that are structured as taxable REIT subsidiaries.

Other

Non-GAAP Financial Measures

We believe that net income and net income attributable to common stockholders, as defined by U.S. GAAP, are the most appropriate earnings measurements. However, we consider FFO, NOI, SSNOI, EBITDA and Adjusted EBITDA to be useful supplemental measures of our operating performance. Historical cost accounting for real estate assets in accordance with U.S. GAAP implicitly assumes that the value of real estate assets diminishes predictably over time as evidenced by the provision for depreciation. However, since real estate values have historically risen or fallen with market conditions, many industry investors and analysts have considered presentations of operating results for real estate companies that use historical cost accounting to be insufficient. In response, the National Association of Real Estate Investment Trusts (“NAREIT”) created funds from operations attributable to common stockholders (“FFO”) as a supplemental measure of operating performance for REITs that excludes historical cost depreciation from net income. FFO, as defined by NAREIT, means NICS, computed in accordance with U.S. GAAP, excluding gains (or losses) from sales of real estate and impairment of depreciable assets, plus depreciation and amortization, and after adjustments for unconsolidated entities and noncontrolling interests.

NOI is used to evaluate the operating performance of our properties. We define NOI as total revenues, including tenant reimbursements, less property operating expenses. Property operating expenses represent costs associated with managing, maintaining and servicing tenants for our properties. These expenses include, but are not limited to, property-related payroll and benefits, property management fees paid to managers, marketing, housekeeping, food service, maintenance, utilities, property taxes and insurance. General and administrative expenses represent general overhead costs that are unrelated to property operations and unallocable to the properties. These expenses include, but are not limited to, payroll and benefits related to corporate employees, professional services, office expenses and depreciation of corporate fixed assets. Same store NOI (“SSNOI”) is used to evaluate the operating performance of our properties using a consistent population which controls for changes in the composition of our portfolio. We believe the drivers of property level NOI for both consolidated properties and unconsolidated properties are generally the same and therefore, we evaluate SSNOI based on our ownership interest in each property ("Welltower Share"). To arrive at Welltower's Share, NOI is adjusted by adding our minority ownership share related to unconsolidated properties and by subtracting the minority partners' noncontrolling ownership interests for consolidated properties. We do not control investments in unconsolidated properties and while we consider disclosures at Welltower Share to be useful, they may not accurately depict the legal and economic implications of our joint venture arrangements and should be used with caution. As used herein, same store is generally defined as those revenue-generating properties in the portfolio for the relevant year-over-year reporting periods. Acquisitions and development conversions are included in SSNOI five full quarters or eight full quarters after acquisition or being placed into service for the QTD Pool and the YTD Pool, respectively. Land parcels, loans and sub-leases, as well as any properties sold or classified as held for sale during the respective periods are excluded from SSNOI. Redeveloped properties (including major refurbishments of a Seniors Housing Operating property

65

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

where 20% or more of units are simultaneously taken out of commission for 30 days or more or Outpatient Medical properties undergoing a change in intended use) are excluded from SSNOI until five full quarters or eight full quarters post completion of the redevelopment for the QTD Pool and YTD Pool, respectively. Properties undergoing operator transitions and/or segment transitions are also excluded from SSNOI until five full quarters or eight full quarters post completion of the transition for the QTD Pool and YTD Pool, respectively. In addition, properties significantly impacted by force majeure, acts of God, or other extraordinary adverse events are excluded from SSNOI until five full quarters or eight full quarters after the properties are placed back into service for the QTD Pool and YTD Pool, respectively. SSNOI excludes non-cash NOI and includes adjustments to present consistent ownership percentages and to translate Canadian properties and U.K. properties using a consistent exchange rate. We believe NOI and SSNOI provide investors relevant and useful information because they measure the operating performance of our properties at the property level on an unleveraged basis. We use NOI and SSNOI to make decisions about resource allocations and to assess the property level performance of our properties.

EBITDA is defined as earnings (net income) before interest, taxes, depreciation and amortization. Adjusted EBITDA is defined as EBITDA excluding unconsolidated entities and including adjustments for stock-based compensation expense, provision for loan losses, gains/losses on extinguishment of debt, gains/loss/impairments on properties, gains/losses on derivatives and financial instruments, other expenses, other impairment charges and other adjustments as deemed appropriate. We believe that EBITDA and Adjusted EBITDA, along with net income, are important supplemental measures because they provide additional information to assess and evaluate the performance of our operations. We primarily use these measures to determine our interest coverage ratio, which represents EBITDA and Adjusted EBITDA divided by total interest, and our fixed charge coverage ratio, which represents EBITDA and Adjusted EBITDA divided by fixed charges. Fixed charges include total interest and secured debt principal amortization. Covenants in our unsecured senior notes and primary credit facility contain financial ratios based on a definition of EBITDA and Adjusted EBITDA that is specific to those agreements. Our leverage ratios are defined as the proportion of net debt to total capitalization and include book capitalization, undepreciated book capitalization and market capitalization. Book capitalization represents the sum of net debt (defined as total long-term debt, excluding operating lease liabilities, less cash and cash equivalents and restricted cash), total equity and redeemable noncontrolling interests. Undepreciated book capitalization represents book capitalization adjusted for accumulated depreciation and amortization. Market capitalization represents book capitalization adjusted for the fair market value of our common stock.

Our supplemental reporting measures and similarly entitled financial measures are widely used by investors, equity and debt analysts and rating agencies in the valuation, comparison, rating and investment recommendations of companies. Management uses these financial measures to facilitate internal and external comparisons to our historical operating results and in making operating decisions. Additionally, these measures are utilized by the Board of Directors to evaluate management. None of our supplemental measures represent net income or cash flow provided from operating activities as determined in accordance with U.S. GAAP and should not be considered as alternative measures of profitability or liquidity. Finally, the supplemental measures, as defined by us, may not be comparable to similarly entitled items reported by other real estate investment trusts or other companies.

The table below reflects the reconciliation of FFO to NICS, the most directly comparable U.S. GAAP measure, for the periods presented. Noncontrolling interest and unconsolidated entity amounts represent adjustments to reflect our share of depreciation and amortization, gains/loss on real estate dispositions and impairment of assets. Amounts are in thousands except for per share data.

Year Ended December 31,
FFO Reconciliation:202320222021
Net income attributable to common stockholders$340,094$141,214$336,138
Depreciation and amortization1,401,1011,310,3681,037,566
Impairment of assets36,09717,50251,107
Loss (gain) on real estate dispositions, net(67,898)(16,043)(235,375)
Noncontrolling interests(46,393)(56,529)(54,190)
Unconsolidated entities100,22681,56085,476
Funds from operations attributable to common stockholders$1,763,227$1,478,072$1,220,722
Average diluted shares outstanding:518,701465,158426,841
Per diluted share data:
Net income attributable to common stockholders(1)$0.66$0.30$0.78
Funds from operations attributable to common stockholders$3.40$3.18$2.86
(1) Includes adjustment to the numerator for income (loss) attributable to OP Unitholders.

66

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The tables below reflects the reconciliation of consolidated NOI to net income, the most directly comparable U.S. GAAP measure, for the years presented (dollars in thousands):

Year Ended December 31,
NOI Reconciliation:202320222021
Net income (loss)$358,139$160,568$374,479
Loss (gain) on real estate dispositions, net(67,898)(16,043)(235,375)
Loss (income) from unconsolidated entities53,44221,29022,933
Income tax expense (benefit)6,3647,2478,713
Other expenses108,341101,67041,739
Impairment of assets36,09717,50251,107
Provision for loan losses, net9,80910,3207,270
Loss (gain) on extinguishment of debt, net768049,874
Loss (gain) on derivatives and financial instruments, net(2,120)8,334(7,333)
General and administrative expenses179,091150,390126,727
Depreciation and amortization1,401,1011,310,3681,037,566
Interest expense607,846529,519489,853
Consolidated net operating income (NOI)$2,690,219$2,301,845$1,967,553
NOI by segment:
Seniors Housing Operating$1,118,135$953,372$683,906
Triple-net1,001,135887,024841,122
Outpatient Medical519,199472,760448,350
Non-segment/corporate51,750(11,311)(5,825)
Total NOI$2,690,219$2,301,845$1,967,553
Quarterly NOI by Segment:
(in thousands)Three Months EndedYear Ended
March 31,June 30,September 30,December 31,December 31,
2023202220232022202320222023202220232022
Seniors Housing Operating:
Total revenues$1,136,681$996,612$1,164,439$1,071,210$1,203,899$1,072,600$1,268,624$1,104,995$4,773,643$4,245,417
Property operating expenses883,784789,928885,187789,299918,990841,914967,547870,9043,655,5083,292,045
Consolidated NOI$252,897$206,684$279,252$281,911$284,909$230,686$301,077$234,091$1,118,135$953,372
Triple-net:
Total revenues$238,065$235,163$302,128$234,360$236,322$228,819$266,814$233,165$1,043,329$931,507
Property operating expenses11,72311,21110,59811,49110,04411,4959,82910,28642,19444,483
Consolidated NOI$226,342$223,952$291,530$222,869$226,278$217,324$256,985$222,879$1,001,135$887,024
Outpatient Medical:
Total revenues$184,831$163,323$186,192$166,322$191,958$172,178$188,174$176,934$751,155$678,757
Property operating expenses58,36549,91558,69750,64862,20452,92152,69052,513231,956205,997
Consolidated NOI$126,466$113,408$127,495$115,674$129,754$119,257$135,484$124,421$519,199$472,760
Corporate:
Total revenues$1,152$606$12,719$644$29,834$247$26,163$3,437$69,868$4,934
Property operating expenses3,8812,6154,1902,6454,0355,8506,0125,13518,11816,245
Consolidated NOI$(2,729)$(2,009)$8,529$(2,001)$25,799$(5,603)$20,151$(1,698)$51,750$(11,311)

67

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a reconciliation of the properties included in our QTD Pool and YTD Pool for SSNOI:

QTD PoolYTD Pool
SSNOI Property Reconciliations:Seniors Housing OperatingTriple-netOutpatient MedicalTotalSeniors Housing OperatingTriple-netOutpatient MedicalTotal
Consolidated properties9186143691,9019186143691,901
Unconsolidated properties823978199823978199
Total properties1,0006534472,1001,0006534472,100
Recent acquisitions/development conversions(1)(78)(74)(42)(194)(169)(74)(53)(296)
Under development(32)(11)(43)(32)(11)(43)
Under redevelopment(2)(5)(4)(2)(11)(5)(4)(2)(11)
Current held for sale(37)(40)(4)(81)(37)(40)(4)(81)
Land parcels, loans and subleases(19)(5)(8)(32)(19)(5)(8)(32)
Transitions(3)(168)(162)(330)(168)(162)(330)
Other(4)(14)(4)(3)(21)(14)(4)(3)(21)
Same store properties6473643771,3885563643661,286
(1) Acquisitions and development conversions will enter the QTD Pool five full quarters and the YTD Pool eight full quarters after acquisition or certificate of occupancy.
(2) Redevelopment properties will enter the QTD Pool after five full quarters and the YTD Pool after eight full quarters of operations post redevelopment completion.
(3) Transitioned properties will enter the QTD Pool after five full quarters and the YTD Pool after eight full quarters of operations with the new operator in place or under the new structure.
(4) Represents properties that are either closed or being closed.

68

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a reconciliation of our consolidated NOI to same store NOI for the periods presented for the respective pools (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedTwelve Months Ended
SSNOI Reconciliations:December 31, 2023December 31, 2022December 31, 2023December 31, 2022
Seniors Housing Operating:
Consolidated NOI$301,077$234,091$1,118,135$953,372
NOI attributable to unconsolidated investments20,48811,29165,28147,190
NOI attributable to noncontrolling interests(15,976)(16,718)(63,867)(122,874)
NOI attributable to non-same store properties(67,994)(35,860)(330,696)(223,436)
Non-cash NOI attributable to same store properties(186)(1,064)(89)(1,374)
Currency and ownership adjustments (1)(416)1,409(159)1,442
SSNOI at Welltower Share236,993193,149788,605654,320
Triple-net:
Consolidated NOI256,985222,8791,001,135887,024
NOI attributable to unconsolidated investments5,7118,94727,57429,516
NOI attributable to noncontrolling interests(8,031)(9,555)(31,373)(41,099)
NOI attributable to non-same store properties(138,314)(104,199)(518,519)(404,629)
Non-cash NOI attributable to same store properties(5,551)(10,800)(39,949)(42,090)
Currency and ownership adjustments (1)(581)355(2,630)(2,165)
SSNOI at Welltower Share110,219107,627436,238426,557
Outpatient Medical:
Consolidated NOI135,484124,421519,199472,760
NOI attributable to unconsolidated investments4,5864,71218,92519,233
NOI attributable to noncontrolling interests(2,308)(5,576)(15,400)(22,089)
NOI attributable to non-same store properties(12,799)(5,700)(60,144)(25,343)
Non-cash NOI attributable to same store properties(5,262)(5,369)(16,566)(14,831)
Currency and ownership adjustments (1)52,6925,94511,934
SSNOI at Welltower Share119,706115,180451,959441,664
SSNOI at Welltower Share:
Seniors Housing Operating236,993193,149788,605654,320
Triple-net110,219107,627436,238426,557
Outpatient Medical119,706115,180451,959441,664
Total$466,918$415,956$1,676,802$1,522,541
(1) Includes adjustments to reflect consistent property ownership percentages, to translate Canadian properties at a USD/CAD rate of 1.37 and to translate U.K. properties at a GBP/USD rate of 1.20.

69

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The table below reflects the reconciliation of EBITDA and Adjusted EBITDA to net income, the most directly comparable U.S. GAAP measure, for the periods presented. Dollars are in thousands.

Year Ended December 31,
Adjusted EBITDA Reconciliation:202320222021
Net income (loss)$358,139$160,568$374,479
Interest expense607,846529,519489,853
Income tax expense (benefit)6,3647,2478,713
Depreciation and amortization1,401,1011,310,3681,037,566
EBITDA2,373,4502,007,7021,910,611
Loss (income) from unconsolidated entities53,44221,29022,933
Stock-based compensation expense36,61126,02716,933
Loss (gain) on extinguishment of debt, net768049,874
Loss (gain) on real estate dispositions, net(67,898)(16,043)(235,375)
Impairment of assets36,09717,50251,107
Provision for loan losses, net9,80910,3207,270
Loss (gain) on derivatives and financial instruments, net(2,120)8,334(7,333)
Other expenses108,341101,67041,739
Lease termination and leasehold interest adjustment (1)(65,485)(64,854)760
Casualty losses, net of recoveries10,10710,3915,786
Other impairment, net (2)16,642(620)49,241
Adjusted EBITDA$2,509,003$2,122,399$1,913,546
Adjusted Interest Coverage Ratio:
Interest expense$607,846$529,519$489,853
Capitalized interest50,69930,49119,352
Non-cash interest expense(23,494)(21,754)(17,506)
Total interest635,051538,256491,699
EBITDA$2,373,450$2,007,702$1,910,611
Interest coverage ratio3.74x3.73x3.89x
Adjusted EBITDA$2,509,003$2,122,399$1,913,546
Adjusted interest coverage ratio3.95x3.94x3.89x
Adjusted Fixed Charge Coverage Ratio:
Total interest$635,051$538,256$491,699
Secured debt principal payments54,07658,11465,587
Total fixed charges689,127596,370557,286
EBITDA$2,373,450$2,007,702$1,910,611
Fixed charge coverage ratio3.44x3.37x3.43x
Adjusted EBITDA$2,509,003$2,122,399$1,913,546
Adjusted fixed charge coverage ratio3.64x3.56x3.43x

(1) Primarily relates to the derecognition of leasehold interests and the gain recognized in other income.

(2) Represents the write off or recovery of straight-line rent receivables balances relating to leases placed on cash recognition.

70

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Our leverage ratios include book capitalization, undepreciated book capitalization and market capitalization. Book capitalization represents the sum of net debt (defined as total long-term debt excluding operating lease liabilities less cash and cash equivalents and restricted cash), total equity and redeemable noncontrolling interests. Undepreciated book capitalization represents book capitalization adjusted for accumulated depreciation and amortization. Market capitalization represents book capitalization adjusted for the fair market value of our common stock. Our leverage ratios are defined as the proportion of net debt to total capitalization. The table below reflects the reconciliation of our leverage ratios to our balance sheets for the periods presented. Amounts are in thousands, except share price.

Year Ended December 31,
202320222021
Book capitalization:
Unsecured credit facility and commercial paper$$$324,935
Long-term debt obligations(1)15,815,22614,661,55213,917,702
Cash and cash equivalents and restricted cash(2,076,083)(722,292)(346,755)
Total net debt13,739,14313,939,26013,895,882
Total equity and noncontrolling interests(2)26,371,72721,393,99618,997,873
Book capitalization$40,110,870$35,333,256$32,893,755
Net debt to book capitalization ratio34.3%39.5%42.2%
Undepreciated book capitalization:
Total net debt$13,739,143$13,939,260$13,895,882
Accumulated depreciation and amortization9,274,8148,075,7336,910,114
Total equity and noncontrolling interests(2)26,371,72721,393,99618,997,873
Undepreciated book capitalization$49,385,684$43,408,989$39,803,869
Net debt to undepreciated book capitalization ratio27.8%32.1%34.9%
Market capitalization:
Common shares outstanding564,241490,509447,239
Period end share price$90.17$65.55$85.77
Common equity market capitalization$50,877,611$32,152,865$38,359,689
Total net debt13,739,14313,939,26013,895,882
Noncontrolling interests(2)967,3511,099,1821,361,872
Market capitalization:$65,584,105$47,191,307$53,617,443
Net debt to market capitalization ratio20.9%29.5%25.9%

(1) Amounts include senior unsecured notes, secured debt and lease liabilities related to finance leases, as reflected on our Consolidated Balance Sheets. Operating lease liabilities related to the ASC 842 adoption are excluded.

(2) Includes amounts attributable to both redeemable noncontrolling interests and noncontrolling interests as reflected on our Consolidated Balance Sheets.

Critical Accounting Policies and Estimates

Our consolidated financial statements are prepared in accordance with U.S. GAAP, which requires us to make estimates and assumptions. Management considers an accounting estimate or assumption critical if:

•the nature of the estimates or assumptions is material due to the levels of subjectivity and judgment necessary to account for highly uncertain matters or the susceptibility of such matters to change; and

•the impact of the estimates and assumptions on financial condition or operating performance is material.

Management has discussed the development and selection of its critical accounting policies and estimates with the Audit Committee of the Board of Directors. Management believes the current assumptions and other considerations used to estimate amounts reflected in our consolidated financial statements are appropriate and are not reasonably likely to change in the future. However, since these estimates require assumptions to be made that were uncertain at the time the estimate was made, they bear the risk of change. If actual experience differs from the assumptions and other considerations used in estimating amounts reflected in our consolidated financial statements, the resulting changes could have a material adverse effect on our consolidated results of operations, liquidity and/or financial condition. Please refer to Note 2 to our consolidated financial statements for further information on significant accounting policies that impact us and for the impact of new accounting standards, including accounting pronouncements that were issued but not yet adopted by us.

71

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following table presents information about our critical accounting policies and estimates:

Nature of Critical Accounting EstimateAssumptions/Approach Used
Impairment of Real Property Owned and Investments in Unconsolidated Entities Assessing impairment of real property owned and investments in unconsolidated entities involves subjectivity in determining if indicators of impairment are present and in estimating the future undiscounted cash flows or estimated fair value of an asset. This evaluation of indicators of impairment is dependent on a number of factors including when there is an event or adverse change in the operating performance of the property, or a change in management's intent to hold and operate the property. If an indicator of impairment of the property is identified, management estimates whether the carrying value is recoverable using observable and unobservable inputs such as historical and forecasted cash flows and estimated capitalization rates, all of which are affected by our expectations of future market or economic conditions. These inputs can have a significant impact on the undiscounted cash flows. The evaluation of indicators of impairment of investments in unconsolidated entities is dependent on a number of factors including the performance of each investment, a change in market conditions or a change in management's investment strategy. When required, we estimate the fair value of an investment and assess whether any impairment is other than temporary using observable and unobservable inputs such as historical and forecasted cash flows and estimated capitalization rates. These inputs can have a significant impact on the calculation of the fair value of the investment.Quarterly, we review our real property owned on a property by property basis to determine if facts and circumstances suggest the property may be impaired. These indicators may include expected operational performance, the tenant's ability to make rent payments, a change in management's intent to hold and operate the property and changes in the market that may permanently reduce the value of the property. If indicators of impairment exist, an undiscounted cash flow analysis will be prepared to determine if the value of the property will be recoverable. If the estimated undiscounted cash flows indicate that the carrying value of the property will not be recoverable, the carrying value of the property is reduce to its estimated fair value and an impairment charge is recognized for the difference between the carrying value and the fair value. This analysis requires us to use judgment in determining whether indicators of impairment exist and to estimate the expected future undiscounted cash flows or estimated fair values of the property. Properties that meet the held for sale criteria are recorded at the lesser of the fair value less costs to sell or carrying value. We also evaluate investments in unconsolidated entities for indicators of impairment and, when present, record impairment charges based upon a comparison of the estimated fair value of the equity method investment to its carrying value if the decline in the estimated fair value of such an investment below its carrying value is other-than-temporary. At December 31, 2023, our net real property owned was approximately $37,063,357,000 and investments in unconsolidated entities totaled $1,636,531,000. During the year ended December 31, 2023, we recorded impairment charges of $15,401,000 related to two Seniors Housing Operating properties and one Triple-net property which were classified as held for sale for which the carrying values exceeded the fair values less costs to sell. Additionally, we recorded $20,696,000 of impairment charges related to three Seniors Housing Operating properties and two Triple-net properties that were held for use in which the carrying values exceeded the estimated fair values. We recorded $35,293,000 of impairment losses related to investments in unconsolidated entities.

72

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Column 1Column 2
Real Estate Acquisitions We believe that substantially all of our real estate acquisitions are considered asset acquisitions for which we record the related real estate acquired (tangible assets and identifiable intangible assets and liabilities) at cost on a relative fair value basis. Liabilities assumed and any associated noncontrolling interests are reflected at fair value. Tangible assets consist primarily of land, building and improvements. Identifiable intangible assets and liabilities primarily consist of the above or below market component of in-place leases and the value of in-place leases. The total amount of other intangible assets acquired is further allocated to in-place lease values and customer relationship values based on management's evaluation of the specific characteristics of each tenant's lease and our overall relationship with respect to that tenant.The allocation of the purchase price to the related real estate acquired (tangible assets and intangible assets and liabilities) are based on a relative fair value analysis. In determining the fair values that drive such analysis, we estimate the fair value of each component of the real estate acquired which generally includes land, buildings and improvements, the above or below market component of in-place leases and the value of in-place leases using a number of sources including independent appraisals, our own analysis of recently acquired or developed and existing comparable properties in our portfolio and other market data. Significant assumptions used to determine such fair values include comparable land sales, capitalization rates, discount rates, market rental rates and property operating data, all of which can be impacted by expectations about future market or economic conditions. Our estimates of the values of these components affect the amount of depreciation and amortization we record over the estimated useful life of the property or the term of the lease. During the year ended December 31, 2023, we disbursed $3,558,266,000 of cash related to real estate acquisitions. These transactions were accounted for as asset acquisitions and the purchase price of each was allocated based on the relative fair values of the assets acquired and liabilities assumed.

73

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Nature of Critical Accounting EstimateAssumptions/Approach Used
Principles of Consolidation The consolidated financial statements include our accounts, the accounts of our wholly owned subsidiaries, and the accounts of joint venture entities in which we own a majority voting interest with the ability to control operations and where no substantive participating rights or substantive kick out rights have been granted to the noncontrolling interests. In addition, we consolidate those entities deemed to be variable interest entities (“VIEs”) in which we are determined to be the primary beneficiary. All material intercompany transactions and balances have been eliminated in consolidation.We make judgments about which entities are VIEs based on an assessment of whether (i) the equity investors as a group, if any, do not have a controlling financial interest, or (ii) the equity investment at risk is insufficient to finance that entity’s activities without additional subordinated financial support. We make judgments with respect to our level of influence or control of an entity and whether we are (or are not) the primary beneficiary of a VIE. Consideration of various factors include, but is not limited to, our ability to direct the activities that most significantly impact the entity's economic performance, our form of ownership interest, our representation on the entity's governing body, the size and seniority of our investment, our ability and the rights of other investors to participate in policy making decisions, replace the manager and/or liquidate the entity, if applicable. Our ability to correctly assess our influence or control over an entity at inception of our involvement or on a continuous basis when determining the primary beneficiary of a VIE affects the presentation of these entities in our consolidated financial statements. If we perform a primary beneficiary analysis at a date other than at inception of the VIE, our assumptions may be different and may result in the identification of a different primary beneficiary.
Allowance for Credit Losses on Loans Receivable The allowance for credit losses is maintained at a level believed adequate to absorb potential losses in our loans receivable. The determination of the credit allowance is based on a quarterly evaluation of all outstanding loans, including general economic conditions and estimated collectability of loan payments.The determination of the allowance for credit losses is based on a quarterly evaluation of all outstanding loans, including general economic conditions and estimated collectability of loan payments. We evaluate the collectability of our loans receivable based on a combination of factors, including, but not limited to, payment status, historical loan charge-offs, financial strength of the borrower and guarantors, and nature, extent and value of the underlying collateral. A loan is considered to have deteriorated credit quality when, based on current information and events, it is probable that we will be unable to collect all amounts due as scheduled according to the contractual terms of the loan agreement. For those loans we identified as having deteriorated credit quality, we determine the amount of credit loss on an individual basis. Placement on non-accrual status may be required. Consistent with this definition, all loans on non-accrual are deemed to have deteriorated credit quality. To the extent circumstances improve and the risk of collectability is diminished, we may return these loans to income accrual status. While a loan is on non-accrual status, any cash receipts are applied against the outstanding principal balance. For the remaining loans, we assess credit loss on a collective pool basis and use our historical loss experience for similar loans to determine the reserve for credit losses. During the year ended December 31, 2023, we recognized provision for loan losses of $9,809,000, which includes changes in the reserve based on our historical loss experience.

74

FY 2022 10-K MD&A

SEC filing source: 0000766704-23-000010.

Extracted structurally from real Item 7 body heading to real Item 7A/8 boundary. Confidence: high. Filing date: 2023-02-21. Report date: 2022-12-31.

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

EXECUTIVE SUMMARY
Company Overview51
Business Strategy52
Key Transactions53
Key Performance Indicators, Trends and Uncertainties53
Corporate Governance55
LIQUIDITY AND CAPITAL RESOURCES
Sources and Uses of Cash55
Off-Balance Sheet Arrangements56
Contractual Obligations57
Capital Structure57
RESULTS OF OPERATIONS
Summary58
Seniors Housing Operating59
Triple-net63
Outpatient Medical65
Non-Segment/Corporate67
OTHER
Non-GAAP Financial Measures67
Critical Accounting Policies and Estimates73

50

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following discussion and analysis is based primarily on the consolidated financial statements of Welltower Inc. presented in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for the periods presented and should be read together with the notes thereto contained in this Annual Report on Form 10-K. Other important factors are identified in “Item 1 — Business” and “Item 1A — Risk Factors” above.

On March 7, 2022, we announced our intent to complete an UPREIT reorganization. In February 2022, the company formerly known as Welltower Inc. ("Old Welltower") formed WELL Merger Holdco Inc. ("New Welltower") as a wholly owned subsidiary, and New Welltower formed WELL Merger Holdco Sub Inc. ("Merger Sub") as a wholly owned subsidiary. On April 1, 2022, Merger Sub merged with and into Old Welltower, with Old Welltower continuing as the surviving corporation and a wholly owned subsidiary of New Welltower. In connection with the Merger, Old Welltower's name was changed to "Welltower OP Inc.", and New Welltower inherited the name "Welltower Inc." Effective May 24, 2022, Welltower OP Inc. ("Welltower OP") converted from a Delaware corporation into a Delaware limited liability company named Welltower OP LLC. Following the LLC Conversion, New Welltower's business continues to be conducted through Welltower OP and New Welltower does not have substantial assets or liabilities, other than through its investment in Welltower OP.

Unless stated otherwise or the context otherwise requires, references to "Welltower" mean Welltower Inc. and references to "Welltower OP" mean Welltower OP LLC. References to "we," "us" and "our" mean collectively Welltower, Welltower OP and those entities/subsidiaries owned or controlled by Welltower and/or Welltower OP.

Executive Summary

Company Overview

Welltower Inc. (NYSE:WELL), an S&P 500 company headquartered in Toledo, Ohio, is driving the transformation of health care infrastructure. The Company invests with leading seniors housing operators, post-acute providers and health systems to fund the real estate and infrastructure needed to scale innovative care delivery models and improve people’s wellness and overall health care experience. Welltower Inc., a real estate investment trust (“REIT”), owns interests in properties concentrated in major, high-growth markets in the United States ("U.S."), Canada and the United Kingdom ("U.K."), consisting of seniors housing and post-acute communities and outpatient medical properties.

Welltower Inc. is the initial member and majority owner of Welltower OP, with an approximate ownership interest of 99.751% as of December 31, 2022. All of our property ownership, development and related business operations are conducted through Welltower OP and Welltower Inc. has no material assets or liabilities other than its investment in Welltower OP. Welltower Inc. issues equity from time to time, the net proceeds of which it is obligated to contribute as additional capital to Welltower OP. All debt including credit facilities, senior notes and secured debt is incurred by Welltower OP, and Welltower Inc. has fully and conditionally guaranteed all existing and future senior unsecured notes.

The following table summarizes our consolidated portfolio for the year ended December 31, 2022 (dollars in thousands):

Percentage ofNumber of
Type of PropertyNOI(1)NOIProperties
Seniors Housing Operating$953,37241.2%850
Triple-net887,02438.3%570
Outpatient Medical472,76020.5%323
Totals$2,313,156100.0%1,743

(1) Represents consolidated net operating income ("NOI") and excludes our share of investments in unconsolidated entities. Entities in which we have a joint venture with a minority partner are shown at 100% of the joint venture amount. See Non-GAAP Financial Measures for additional information and reconciliation.

The COVID-19 pandemic has had and may continue to have material and adverse effects on our financial condition, results of operations and cash flows in the future. The extent to which the COVID-19 pandemic impacts our operations and those of our operators and tenants will depend on future developments, which are highly uncertain and cannot be predicted with confidence, including the scope, severity and duration of the pandemic, the effectiveness of vaccines, the actions taken to contain the pandemic or mitigate its impact and the direct and indirect economic effects of the pandemic and containment measures, the overall pace of recovery, among others.

Our Seniors Housing Operating revenues are dependent on occupancy which has increased during the year ended December 31, 2022. As of December 31, 2022, nearly all communities are open for new admissions and allowing visitors, in-person tours and communal dining activities.

We have incurred increased operational costs as a result of public health measures and other regulations affecting our properties, as well as additional health and safety measures adopted by us and our operators related to the COVID-19 pandemic, including increases in labor, personal protective equipment and sanitation. We expect total Seniors Housing Operating expenses to remain elevated as many of these additional health and safety measures have become standard practice.

51

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Our Triple-net operators are experiencing similar trends related to occupancy and operating costs as described above with respect to our Seniors Housing Operating properties. However, long-term/post-acute care facilities are generally experiencing a higher degree of occupancy declines. These factors may continue to impact the ability of our Triple-net operators to make contractual rent payments to us in the future. Many of our Triple-net operators received funds under the Coronavirus Aid Relief, and Economic Security Act (“CARES Act”) Paycheck Protection Program and Provider Relief Fund.

Business Strategy

Our primary objectives are to protect stockholder capital and enhance stockholder value. We seek to pay consistent cash dividends to stockholders and create opportunities to increase dividend payments to stockholders as a result of annual increases in NOI and portfolio growth. To meet these objectives, we invest across the full spectrum of seniors housing and health care real estate and diversify our investment portfolio by property type, relationship and geographic location.

Substantially all of our revenues are derived from operating lease rentals, resident fees and services and interest earned on outstanding loans receivable. These items represent our primary sources of liquidity to fund distributions and depend upon the continued ability of our obligors to make contractual rent and interest payments to us and the profitability of our operating properties. To the extent that our obligors/partners experience operating difficulties and become unable to generate sufficient cash to make payments or operating distributions to us, there could be a material adverse impact on our consolidated results of operations, liquidity and/or financial condition. To mitigate this risk, we monitor our investments through a variety of methods determined by the type of property. Our asset management process for seniors housing properties generally includes review of monthly financial statements and other operating data for each property, review of obligor/partner creditworthiness, property inspections and review of covenant compliance relating to licensure, real estate taxes, letters of credit and other collateral. Our internal property management division manages and monitors the outpatient medical portfolio with a comprehensive process including review of tenant relations, lease expirations, the mix of health service providers, hospital/health system relationships, property performance, capital improvement needs and market conditions among other things. We evaluate the operating environment in each property’s market to determine the likely trend in operating performance of the facility. When we identify unacceptable trends, we seek to mitigate, eliminate or transfer the risk. Through these efforts, we generally aim to intervene at an early stage to address any negative trends, and in so doing, support both the collectability of revenue and the value of our investment.

In addition to our asset management and research efforts, we also aim to structure our relevant investments to mitigate payment risk. Operating leases and loans are normally credit enhanced by guarantees and/or letters of credit. In addition, operating leases are typically structured as master leases and loans are generally cross-defaulted and cross-collateralized with other real estate loans, operating leases or agreements between us and the obligor and its affiliates.

For the year ended December 31, 2022, resident fees and services and rental income represented 71% and 25%, respectively, of total revenues. Substantially all of our operating leases are designed with escalating rent structures. Leases with fixed annual rental escalators are generally recognized on a straight-line basis over the initial lease period, subject to a collectability assessment. Rental income related to leases with contingent rental escalators is generally recorded based on the contractual cash rental payments due for the period. Our yield on loans receivable depends upon a number of factors, including the stated interest rate, the average principal amount outstanding during the term of the loan and any interest rate adjustments.

Our primary sources of cash include resident fees and services, rent and interest receipts, borrowings under our unsecured revolving credit facility and commercial paper program, public issuances of debt and equity securities, proceeds from investment dispositions and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including acquisitions, capital expenditures, construction advances and transaction costs), loan advances, property operating expenses, general and administrative expenses and other expenses. Depending upon the availability and cost of external capital, we believe our liquidity is sufficient to fund these uses of cash.

We also continuously evaluate opportunities to finance future investments. New investments are generally funded from temporary borrowings under our unsecured revolving credit facility and commercial paper program, internally generated cash and the proceeds from investment dispositions. Our investments generate cash from NOI and principal payments on loans receivable. Permanent financing for future investments, which replaces funds drawn under our unsecured revolving credit facility and commercial paper program, has historically been provided through a combination of the issuance of public debt and equity securities and the incurrence or assumption of secured debt.

Depending upon market conditions, we believe that new investments will be available in the future with spreads over our cost of capital that will generate appropriate returns to our stockholders. It is also likely that investment dispositions may occur in the future. To the extent that investment dispositions exceed new investments, our revenues and cash flows from operations could be adversely affected. We expect to reinvest the proceeds from any investment dispositions in new investments. To the extent that new investment requirements exceed our available cash on-hand, we expect to borrow under our unsecured revolving credit facility and commercial paper program. At December 31, 2022, we had $631,681,000 of cash and cash equivalents, $90,611,000 of restricted cash and $4,000,000,000 of available borrowing capacity under our unsecured revolving credit facility.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Key Transactions

Capital  The following summarizes key capital transactions that occurred during the year ended December 31, 2022:

•In March 2022, we completed the issuance of $550,000,000 senior unsecured notes bearing interest at 3.85% with a maturity date of June 2032.

•In April 2022, we entered into an amended and restated ATM Program (as defined below) pursuant to which we may offer and sell up to $3,000,000,000 of common stock from time to time. During 2022, we sold 37,905,638 shares of common stock under our current and previous ATM Programs via forward sale agreements, generating gross proceeds of approximately $3,280,798,000. The sale of these shares and the settlement of outstanding forward sales from prior years resulted in gross proceeds of approximately $3,715,971,000.

•In June 2022, we closed on an amended $5,200,000,000 unsecured credit facility with improved pricing across our term loans. The credit facility includes $4,000,000,000 of revolving credit capacity at a borrowing rate of 77.5 basis points over the adjusted SOFR rate, $1,000,000,000 of USD term loan capacity at a borrowing rate of 85.0 basis points over the adjusted SOFR rate and $250,000,000 CAD term loan capacity at 85.0 basis points over CDOR.

•We extinguished $399,066,000 of secured debt at a blended average interest rate of 5.54% throughout 2022.

Investments The following summarizes property acquisitions and joint venture investments completed during the year ended December 31, 2022 (dollars in thousands):

PropertiesBook Amount(1)Capitalization Rates(2)
Seniors Housing Operating77$2,511,4084.7%
Triple-net566,7840.2%
Outpatient Medical12360,9055.4%
Totals94$2,939,0974.6%

(1) Represents amounts recorded in net real estate investments including fair value adjustments pursuant to U.S. GAAP. See Note 3 to our consolidated financial statements for additional information.

(2) Represents annualized contractual or projected NOI to be received in cash divided by investment amounts.

Dispositions The following summarizes property dispositions completed during the year ended December 31, 2022 (dollars in thousands):

PropertiesProceeds(1)Book Amount(2)Capitalization Rates(3)
Seniors Housing Operating5$88,815$85,413—%
Triple-net11109,91789,8273.8%
Outpatient Medical764393—%
Totals16$199,496$175,6333.8%

(1) Represents pro rata proceeds received upon disposition including any seller financing.

(2) Represents carrying value of net real estate assets at time of disposition. See Note 5 to our consolidated financial statements for additional information.

(3) Represents annualized contractual income that was being received in cash at date of disposition divided by stated purchase price. Excludes properties sold that were recent development conversions.

Dividends Our Board of Directors declared a cash dividend for the quarter ended December 31, 2022 of $0.61 per share. On March 8, 2023, we will pay our 207th consecutive quarterly dividend payment to stockholders of record on February 28, 2023.

Key Performance Indicators, Trends and Uncertainties

We utilize several key performance indicators to evaluate the various aspects of our business. These indicators are discussed below and relate to operating performance, credit strength and concentration risk. Management uses these key performance indicators to facilitate internal and external comparisons to our historical operating results, in making operating decisions, and for budget planning purposes.

Operating Performance We believe that net income and net income attributable to common stockholders (“NICS”) per the Consolidated Statements of Comprehensive Income are the most appropriate earnings measures. Other useful supplemental measures of our operating performance include funds from operations attributable to common stockholders (“FFO”) and consolidated net operating income (“NOI”); however, these supplemental measures are not defined by U.S. GAAP. Please refer to the section entitled “Non-GAAP Financial Measures” for further discussion and reconciliations. These earnings measures are widely used by investors and analysts in the valuation, comparison and investment recommendations of companies.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following table reflects the recent historical trends of our operating performance measures for the periods presented (in thousands):

Year Ended December 31,
202220212020
Net income$160,568$374,479$1,038,852
Net income attributable to common stockholders141,214336,138978,844
Funds from operations attributable to common stockholders1,478,0721,220,7221,102,562
Consolidated net operating income2,301,8451,967,5532,008,144

Credit Strength We measure our credit strength both in terms of leverage ratios and coverage ratios. The leverage ratios indicate how much of our balance sheet capitalization is related to long-term debt, net of cash and restricted cash. The coverage ratios indicate our ability to service interest and fixed charges (interest and secured debt principal amortization). We expect to maintain capitalization ratios and coverage ratios sufficient to maintain a capital structure consistent with our current profile. The coverage ratios are based on earnings before interest, taxes, depreciation and amortization ("EBITDA") and adjusted earnings before interest, taxes, depreciation and amortization (“Adjusted EBITDA”). Please refer to the section entitled “Non-GAAP Financial Measures” for further discussion and reconciliation of these measures. Leverage ratios and coverage ratios are widely used by investors, analysts and rating agencies in the valuation, comparison, investment recommendations and rating of companies. The following table reflects the recent historical trends for our credit strength measures for the periods presented:

Year Ended December 31,
202220212020
Net debt to book capitalization ratio39.5%42.2%40.8%
Net debt to undepreciated book capitalization ratio32.1%34.9%33.8%
Net debt to market capitalization ratio29.5%25.9%29.6%
Interest coverage ratio3.73x3.89x5.04x
Fixed charge coverage ratio3.37x3.43x4.49x
Adjusted interest coverage ratio3.94x3.89x3.97x
Adjusted fixed charge coverage ratio3.56x3.43x3.54x

Concentration Risk We evaluate our concentration risk in terms of NOI by property mix, relationship mix and geographic mix. Concentration risk is a valuable measure in understanding what portion of our NOI could be at risk if certain sectors were to experience downturns. Property mix measures the portion of our NOI that relates to our various property types. Relationship mix measures the portion of our NOI that relates to our current top five relationships. Geographic mix measures the portion of our NOI that relates to our current top five states (or international equivalents). The following table reflects our recent historical trends of concentration risk by NOI for the years indicated below:

December 31,(1)
202220212020
Property mix:
Seniors Housing Operating41%35%38%
Triple-net38%43%37%
Outpatient Medical21%22%25%
Relationship mix:
ProMedica10%12%11%
Sunrise Senior Living7%10%13%
Atria Senior Living(2)6%2%—%
HC-One Group4%3%—%
Cogir Management Corporation3%2%2%
Remaining70%71%74%
Geographic mix:
California14%13%14%
United Kingdom10%13%10%
Texas8%8%9%
Canada6%6%6%
New Jersey6%6%5%
Remaining56%54%56%

(1) Excludes our share of investments in unconsolidated entities and non-segment/corporate NOI. Entities in which we have a joint venture with a minority partner are shown at 100% of the joint venture amount.

(2) Year ended December 31, 2022 includes $58,621,000 of income recognized upon termination of a lease. See Note 3 to our consolidated financial statements for further details.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

In December 2022, ProMedica relinquished to Welltower its 15% interest in 147 skilled nursing facilities previously owned by the Welltower/ProMedica joint venture in exchange for a lease modification, which relieved ProMedica from its lease obligation on the 147 skilled nursing properties and amended the lease on the remaining 58 assisted living and memory care properties that continue to be held by the Welltower/ProMedica joint venture. The 58 assisted living and memory care assets continue to be operated by ProMedica and backed by the existing guaranty.

Concurrently with the above, Welltower and Integra Healthcare Properties ("Integra") entered into master leases for the skilled nursing portfolio. Approximately 15 regional operators will enter into subleases with Integra to operate the properties. Also in December 2022, we sold to Integra a 15% ownership interest in 54 of those skilled nursing facilities for approximately $73 million. This transaction represents the initial tranche of the newly formed joint venture owned 85% by Welltower and 15% by Integra, which is anticipated to include the 147 skilled nursing facilities. In January 2023, Integra acquired a 15% interest in 31 of the remaining 93 skilled nursing facilities for approximately $74 million, representing the second tranche of the WELL/Integra joint venture. Integra is expected to buy into the remaining 62 assets throughout 2023.

ProMedica NOI for the year ended December 31, 2022 was comprised of $59,687,000 relating to the 58 assisted living and memory care properties (3% of total NOI) and $180,441,000 relating to the 147 skilled nursing properties (8% of total NOI).

We evaluate our key performance indicators in conjunction with current expectations to determine if historical trends are indicative of future results. Our expected results may not be achieved and actual results may differ materially from our expectations. Factors that may cause actual results to differ from expected results are described in more detail in “Item 1 — Business — Cautionary Statement Regarding Forward-Looking Statements” and “Item 1A — Risk Factors” and other sections of this Annual Report on Form 10-K. Management regularly monitors economic and other factors to develop strategic and tactical plans designed to improve performance and maximize our competitive position. Our ability to achieve our financial objectives is dependent upon our ability to effectively execute these plans and to appropriately respond to emerging economic and company-specific trends. Please refer to “Item 1 — Business,” “Item 1A — Risk Factors” in this Annual Report on Form 10-K for further discussion of these risk factors.

Corporate Governance

Maintaining investor confidence and trust is important in today’s business environment. Our Board of Directors and management are strongly committed to policies and procedures that reflect the highest level of ethical business practices. Our corporate governance guidelines provide the framework for our business operations and emphasize our commitment to increase stockholder value while meeting all applicable legal requirements. These guidelines meet the listing standards adopted by the New York Stock Exchange and are available on the Internet at www.welltower.com/investors/governance. The information on our website is not incorporated by reference in this Annual Report on Form 10-K, and our web address is included as an inactive textual reference only.

Liquidity and Capital Resources

Sources and Uses of Cash

Our primary sources of cash include resident fees and services, rent and interest receipts, borrowings under our unsecured revolving credit facility and commercial paper program, public issuances of debt and equity securities, proceeds from investment dispositions and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including acquisitions, capital expenditures, construction advances and transaction costs), loan advances, property operating expenses, general and administrative expenses and other expenses. These sources and uses of cash are reflected in our Consolidated Statements of Cash Flows and are discussed in further detail below. The following is a summary of our sources and uses of cash flows for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20222021$%2020$%$%
Cash, cash equivalents and restricted cash at beginning of period$346,755$2,021,043$(1,674,288)-83%$385,766$1,635,277424%$(39,011)-10%
Net cash provided from (used in):
Operating activities1,328,7081,275,32553,3834%1,364,756(89,431)-7%(36,048)-3%
Investing activities(3,703,815)(4,516,268)812,453-18%2,347,928(6,864,196)n/a(6,051,743)n/a
Financing activities2,761,2771,567,6641,193,61376%(2,080,858)3,648,522n/a4,842,135n/a
Effect of foreign currency translation(10,633)(1,009)(9,624)954%3,451(4,460)n/a(14,084)n/a
Cash, cash equivalents and restricted cash at end of period$722,292$346,755$375,537108%$2,021,043$(1,674,288)-83%$(1,298,751)-64%

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Operating Activities The changes in net cash provided from operating activities was immaterial. Please see “Results of Operations” for discussion of net income fluctuations. For the years ended December 31, 2022, 2021 and 2020, cash flows from operations exceeded cash distributions to stockholders.

Investing Activities  The changes in net cash provided from/used in investing activities are primarily attributable to net changes in real property investments and dispositions, loans receivable and investments in unconsolidated entities, which are summarized above in “Key Transactions.” Please refer to Notes 3 and 5 of our consolidated financial statements for additional information. The following is a summary of cash used in non-acquisition capital improvement activities for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20222021$%2020$%$%
New development$631,737$417,963$213,77451%$201,336$216,627108%$430,401214%
Recurring capital expenditures, tenant improvements and lease commissions198,57699,99498,58299%83,14616,84820%115,430139%
Renovations, redevelopments and other capital improvements277,440182,59494,84652%161,84320,75113%115,59771%
Total$1,107,753$700,551$407,20258%$446,325$254,22657%$661,428148%

The change in new development is primarily due to the number and size of construction projects on-going during the relevant periods. Renovations, redevelopments and other capital improvements include expenditures to maximize property value, increase net operating income, maintain a market-competitive position and/or achieve property stabilization. The increase in overall development and recurring capital expenditures, tenant improvements and lease commissions is due primarily to portfolio growth and increased spending after a contraction during the pandemic.

Financing Activities The changes in net cash provided from/used in financing activities are primarily attributable to changes related to our long-term debt arrangements, the issuances of common stock and dividend payments which are summarized above in “Key Transactions.” Please refer to Notes 10, 11 and 14 of our consolidated financial statements for additional information.

In March 2022, we completed the issuance of $550,000,000 senior unsecured notes with a maturity date of June 2032. In April 2022, we closed on an amended $5,200,000,000 unsecured credit facility, increasing our term loan capacity by $500,000,000. As of December 31, 2022, we have total near-term available liquidity of approximately $4.7 billion.

Off-Balance Sheet Arrangements

At December 31, 2022, we had investments in unconsolidated entities with our ownership generally ranging from 10% to 88%. We use financial derivative instruments to hedge interest rate and foreign currency exchange rate exposure. At December 31, 2022, we had 21 outstanding letter of credit obligations. Please see Notes 8, 12 and 13 to our consolidated financial statements for additional information.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Contractual Obligations

The following table summarizes our payment requirements under contractual obligations as of December 31, 2022 (in thousands):

Payments Due by Period
Contractual ObligationsTotal20232024-20252026-2027Thereafter
Senior unsecured notes and term credit facilities:(1)
U.S. Dollar senior unsecured notes$9,900,000$$2,600,000$1,200,000$6,100,000
Canadian Dollar senior unsecured notes(2)221,697221,697
Pounds Sterling senior unsecured notes(2)1,268,0851,268,085
U.S. Dollar term credit facility1,010,00010,0001,000,000
Canadian Dollar term credit facility(2)184,747184,747
Secured debt:(1,2)
Consolidated2,129,954627,672612,517311,945577,820
Unconsolidated1,306,025234,613696,987178,010196,415
Contractual interest obligations:(3)
Senior unsecured notes and term loans(2)3,980,016511,574920,126735,5551,812,761
Consolidated secured debt(2)327,45580,305104,84569,62672,679
Unconsolidated secured debt(2)181,59235,55067,52429,38749,131
Finance lease liabilities(4)206,48972,2185,5913,538125,142
Operating lease liabilities(4)963,23920,27935,55631,350876,054
Purchase obligations(5)2,096,3491,230,913799,82665,610
Total contractual obligations$23,775,648$2,813,124$5,852,972$4,031,465$11,078,087

(1) Amounts represent principal amounts due and do not reflect unamortized premiums/discounts or other fair value adjustments as reflected on the Consolidated Balance Sheets.

(2) Based on foreign currency exchange rates in effect as of balance sheet date.

(3) Based on variable interest rates in effect as of December 31, 2022.

(4) See Note 6 to our consolidated financial statements for additional information.

(5) See Note 13 to our consolidated financial statements for additional information.

Capital Structure

Please refer to “Credit Strength” above for a discussion of our leverage and coverage ratio trends. Our debt agreements contain various covenants, restrictions and events of default. Certain agreements require us to maintain financial ratios and minimum net worth and impose certain limits on our ability to incur indebtedness, create liens and make investments or acquisitions. As of December 31, 2022, we were in compliance in all material respects with the covenants under our debt agreements. None of our debt agreements contain provisions for acceleration which could be triggered by our debt ratings. However, under our primary unsecured credit facility, the ratings on our senior unsecured notes are used to determine the fees and interest charged. We plan to manage the company to maintain compliance with our debt covenants and with a capital structure consistent with our current profile. Any downgrades in terms of ratings or outlook by any or all of the rating agencies could have a material adverse impact on our cost and availability of capital, which could have a material adverse impact on our consolidated results of operations, liquidity and/or financial condition.

On April 1, 2022, Welltower Inc. and Welltower OP LLC jointly filed with the Securities and Exchange Commission (the “SEC”) an open-ended automatic or “universal” shelf registration statement on Form S-3 covering an indeterminate amount of future offerings of Welltower Inc.’s debt securities, common stock, preferred stock, depositary shares, guarantees of debt securities issued by Welltower OP LLC, warrants and units and Welltower OP LLC’s debt securities and guarantees of debt securities issued by Welltower Inc. to replace Old Welltower’s existing “universal” shelf registration statement filed with the SEC on May 4, 2021. On April 1, 2022, Welltower Inc. also filed with the SEC a registration statement in connection with its enhanced dividend reinvestment plan (“DRIP”) under which it may issue up to 15,000,000 shares of common stock to replace Old Welltower’s existing DRIP registration statement on Form S-3 filed with the SEC on May 4, 2021. As of February 16, 2023, 15,000,000 shares of common stock remained available for issuance under the DRIP registration statement. On April 4, 2022, Welltower Inc. entered into (i) a second amended and restated equity distribution agreement (the “EDA”) with (i) Robert W. Baird & Co. Incorporated, Barclays Capital Inc., BMO Capital Markets Corp., BNP Paribas Securities Corp., BNY Mellon Capital Markets, LLC, BofA Securities, Inc., BOK Financial Securities, Inc., Capital One Securities Inc., Citigroup Global Markets Inc., Comerica Securities, Inc., Credit Agricole Securities (USA) Inc., Deutsche Bank Securities Inc., Fifth Third Securities, Inc., Goldman Sachs & Co. LLC, Jefferies LLC, JMP Securities LLC, J.P. Morgan Securities LLC, KeyBanc Capital Markets Inc., Loop Capital Markets LLC, Mizuho Securities USA LLC, Morgan Stanley & Co. LLC, MUFG Securities

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Americas Inc., RBC Capital Markets, LLC, Regions Securities LLC, Scotia Capital (USA) Inc., SMBC Nikko Securities America, Inc., Synovus Securities, Inc., TD Securities (USA) LLC, Truist Securities, Inc. and Wells Fargo Securities, LLC as sales agents and forward sellers and (ii) the forward purchasers named therein relating to issuances, offers and sales from time to time of up to $3,000,000,000 aggregate amount of common stock of Welltower Inc. (together with the existing master forward sale confirmations relating thereto, the “ATM Program”), amending and restating the ATM Program entered into on July 30, 2021 to, among other amendments, increase the total amount of shares of common stock that may be offered and sold under the ATM Program from $2,500,000,000 to $3,000,000,000, which amount excludes shares Old Welltower had previously sold pursuant to the prior program. The ATM Program also allows Welltower Inc. to enter into forward sale agreements. As of February 16, 2023, we had $1,150,202,853 of remaining capacity under the ATM Program and there were no outstanding forward sales agreements. Depending upon market conditions, we anticipate issuing securities under our registration statements to invest in additional properties and to repay borrowings under our unsecured revolving credit facility and commercial paper program.

In connection with the filing of the new “universal” shelf registration statement, Welltower Inc. also filed with the SEC two prospectus supplements that will continue offerings that were previously covered by Old Welltower's prospectus supplements and the accompanying prospectus to the prior registration statement relating to: (i) the registration of up to 620,731 shares of common stock of Welltower Inc. (the “DownREIT Shares”), that may be issued from time to time if, and to the extent that, certain holders of Class A units (the “DownREIT Units”) of HCN G&L DownREIT, LLC, a Delaware limited liability company (the “DownREIT”), tender such DownREIT Units for redemption by the DownREIT, and HCN DownREIT Member, LLC, a majority-owned indirect subsidiary of Welltower Inc. (including its permitted successors and assigns, the “Managing Member”), or a designated affiliate of the Managing Member, elects to assume the redemption obligations of the DownREIT and to satisfy all or a portion of the redemption consideration by issuing DownREIT Shares to the holders instead of or in addition to paying a cash amount; and (ii) the registration of up to 475,327 shares of common stock of Welltower Inc. (the “DownREIT II Shares”), that may be issued from time to time if, and to the extent that, certain holders of Class A units (the “DownREIT II Units,” and collectively with the DownREIT Units, the “Units”) of HCN G&L DownREIT II LLC, a Delaware limited liability company (the “DownREIT II”), tender such DownREIT II Units for redemption by the DownREIT II, and the Managing Member, or a designated affiliate of the Managing Member, elects to assume the redemption obligations of the DownREIT II and to satisfy all or a portion of the redemption consideration by issuing DownREIT II Shares to the holders instead of or in addition to paying a cash amount. On July 22, 2022, Welltower Inc. filed with the SEC a prospectus supplement relating to the registration of up to 300,026 shares of common stock of Welltower Inc. that may be issued from time to time if, and to the extent that, certain holders of Class A Common Units (the "OP Units") of Welltower OP tender the OP Units for redemption by Welltower OP, and Welltower Inc. elects to assume the redemption obligations of Welltower OP and to satisfy all or a portion of the redemption consideration by issuing shares of its common stock to the holders instead of or in addition to paying a cash amount.

Supplemental Guarantor Information

Welltower OP has issued the unsecured notes described in Note 11 to our Consolidated Financial Statements. All unsecured notes are fully and unconditionally guaranteed by Welltower, and Welltower OP is 99.751% owned by Welltower as of December 31, 2022. Effective January 4, 2021, the SEC adopted amendments to the financial disclosure requirements applicable to registered debt offerings that include certain credit enhancements. We have adopted these new rules, which permits subsidiary issuers of obligations guaranteed by the parent to omit separate financial statements if the consolidated financial statements of the parent company have been filed, the subsidiary obligor is a consolidated subsidiary of the parent company, the guaranteed security is debt or debt-like, and the security is guaranteed fully and unconditionally by the parent. Accordingly, separate consolidated financial statements of Welltower OP have not been presented. Furthermore, Welltower and Welltower OP have no material assets, liabilities, or operations other than financing activities and their investments in non-guarantor subsidiaries. Therefore, we meet the criteria in Rule 13-01 of Regulation S-X to omit the summarized financial information from our disclosures.

Results of Operations

Summary

Our primary sources of revenue include resident fees and services, rent and interest income. Our primary expenses include property operating expenses, depreciation and amortization, interest expense, general and administrative expenses, and other expenses. We evaluate our business and make resource allocations on our three business segments: Seniors Housing Operating, Triple-net and Outpatient Medical. The primary performance measures for our properties are NOI and same store NOI ("SSNOI") and other supplemental measures include FFO and Adjusted EBITDA, which are further discussed below. Please see Non-GAAP Financial Measures for additional information and reconciliations related to these supplemental measures.

This section of this Form 10-K generally discusses 2022 and 2021 items and year-to-year comparisons between 2022 and 2021. Discussions of 2020 items and year-to-year comparisons between 2021 and 2020 that are not included

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

in this Form 10-K can be found in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 of the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2021.

The following is a summary of our results of operations for the periods presented (dollars in thousands, except per share amounts):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20222021Amount%2020Amount%Amount%
Net income$160,568$374,479$(213,911)-57%$1,038,852$(664,373)-64%$(878,284)-85%
NICS141,214336,138(194,924)-58%978,844(642,706)-66%(837,630)-86%
FFO1,478,0721,220,722257,35021%1,102,562118,16011%375,51034%
EBITDA2,007,7021,910,61197,0915%2,601,645(691,034)-27%(593,943)-23%
Adjusted EBITDA2,122,3991,913,546208,85311%2,048,412(134,866)-7%73,9874%
NOI2,301,8451,967,553334,29217%2,008,144(40,591)-2%293,70115%
Per share data (fully diluted):
Net income attributable to common stockholders (1)$0.30$0.78$(0.48)-62%$2.33$(1.55)-67%$(2.03)-87%
Funds from operations attributable to common stockholders$3.18$2.86$0.3211%$2.64$0.228%$0.5420%
Interest coverage ratio3.73x3.89x-0.16x-4%5.04x-1.15x-23%-1.31x-26%
Fixed charge coverage ratio3.37x3.43x-0.06x-2%4.49x-1.06x-24%-1.12x-25%
Adjusted interest coverage ratio3.94x3.89x0.05x1%3.97x-0.08x-2%-0.03x-1%
Adjusted fixed charge coverage ratio3.56x3.43x0.13x4%3.54x-0.11x-3%0.02x1%
(1) Includes adjustment to the numerator for income (loss) attributable to OP unitholders.

The following table represents the changes in outstanding common stock for the period from January 1, 2020 to December 31, 2022 (in thousands):

Year Ended
December 31, 2022December 31, 2021December 31, 2020Totals
Beginning balance447,239417,401410,257410,257
Dividend reinvestment plan issuances264264
Redemption of OP Units and DownREIT Units55
Option exercises22
ATM Program issuances43,09329,6676,80079,560
Repurchase of common stock(202)(202)
Other, net169171282622
Ending balance490,508447,239417,401490,508
Weighted average number of shares outstanding:
Basic462,185424,976415,451
Diluted465,158426,841417,387

A portion of our earnings are derived primarily from long-term investments with predictable rates of return. These investments are mainly financed with a combination of equity, senior unsecured notes, secured debt and borrowings under our primary unsecured credit facility. During inflationary periods, which generally are accompanied by rising interest rates, our ability to grow may be adversely affected because the yield on new investments may increase at a slower rate than new borrowing costs.

Seniors Housing Operating

The following is a summary of our results of operations for the Seniors Housing Operating segment for the years presented (dollars in thousands):

59

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20222021$%2020$%$%
Revenues:
Resident fees and services$4,173,711$3,197,223$976,48831%$3,074,022$123,2014%$1,099,68936%
Interest income7,8674,2313,63686%6183,613585%7,249n/a
Other income63,83911,79652,043441%7,2234,57363%56,616784%
Total revenues4,245,4173,213,2501,032,16732%3,081,863131,3874%1,163,55438%
Property operating expenses3,292,0452,529,344762,70130%2,326,311203,0339%965,73442%
NOI(1)953,372683,906269,46639%755,552(71,646)-9%197,82026%
Other expenses:
Depreciation and amortization854,800593,565261,23544%544,46249,1039%310,33857%
Interest expense34,83339,327(4,494)-11%54,901(15,574)-28%(20,068)-37%
Loss (gain) on extinguishment of debt, net386(2,628)3,014115%12,659(15,287)-121%(12,273)-97%
Provision for loan losses, net1,039394645164%671(277)-41%36855%
Impairment of assets13,14622,317(9,171)-41%100,741(78,424)-78%(87,595)-87%
Other expenses66,02627,13238,894143%14,26512,86790%51,761363%
970,230680,107290,12343%727,699(47,592)-7%242,53133%
Income (loss) from continuing operations before income taxes and other items(16,858)3,799(20,657)-544%27,853(24,054)-86%(44,711)-161%
Income (loss) from unconsolidated entities(53,318)(39,225)(14,093)-36%(33,857)(5,368)-16%(19,461)-57%
Gain (loss) on real estate dispositions, net5,7946,146(352)-6%328,249(322,103)-98%(322,455)-98%
Income from continuing operations(64,382)(29,280)(35,102)-120%322,245(351,525)-109%(386,627)-120%
Net income (loss)(64,382)(29,280)(35,102)-120%322,245(351,525)-109%(386,627)-120%
Less: Net income (loss) attributable to noncontrolling interests(16,258)(2,224)(14,034)-631%20,301(22,525)-111%(36,559)-180%
Net income (loss) attributable to common stockholders$(48,124)$(27,056)$(21,068)-78%$301,944$(329,000)-109%$(350,068)-116%

(1) See Non-GAAP Financial Measures below.

Resident fees and services and property operating expenses for the year ended December 31, 2022 increased compared to the prior year primarily due to acquisitions and construction conversions, including the acquisition of the Holiday Retirement portfolio on July 30, 2021 for a total purchase price of $1.6 billion. Additionally, our Seniors Housing Operating revenues are dependent on occupancy, which has steadily increased during 2022. As of December 31, 2022, nearly all communities are open for new admissions and allowing visitors, in-person tours and communal dining activities. Average occupancy is as follows:

Three Months Ended(1)
March 31,June 30,September 30,December 31,
202172.7%73.0%74.9%76.3%
202276.3%77.1%78.0%78.3%

(1) Average occupancy includes our minority ownership share related to unconsolidated properties and excludes the minority partners' noncontrolling ownership share related to consolidated properties. Also excludes land parcels and properties under development.

Effective on April 1, 2022, our leasehold interest relating to the master lease with National Health Investors, Inc. ("NHI") for 17 properties assumed in conjunction with the Holiday Retirement acquisition was terminated as a result of the transition or sale of the properties by NHI. The lease termination was part of an agreement to resolve outstanding litigation with NHI. In conjunction with the agreement, a wholly owned subsidiary and the lessee on the master lease agreed to release $6,883,000 of cash to the landlord, which represents the net cash flow generated from the properties since we assumed the leasehold interest. Additionally, in conjunction with the lease termination, during the year ended December 31, 2022 we recognized $58,621,000 in other income on our Consolidated Statements of Comprehensive Income, from the derecognition of the right of use asset and related lease liability.

Property-level operating expenses associated with the COVID-19 pandemic relating to our Seniors Housing Operating portfolio totaled $33,099,000, $63,681,000 and $110,719,000 for the years ended December 31, 2022, 2021 and 2020, respectively. These expenses were incurred as a result of public health measures and other regulations affecting our properties, as well as additional health and safety measures adopted by us and our operators related to the COVID-19 pandemic, including increases in labor and property cleaning expenses and expenditures related to our efforts to procure personal protective equipment ("PPE") and supplies. We expect total Seniors Housing Operating expenses to remain elevated as certain of these additional health and safety measures have become standard practice.

We received government grants under the CARES Act primarily to cover increased expenses and lost revenue during the COVID-19 pandemic, as well as under similar programs in the U.K. and Canada. We recognized $38,607,000, $97,933,000 and $31,927,000 during the years ended December 31, 2022, 2021 and 2020, respectively. These grants represent a reduction to property operating expenses in our Consolidated Statements of Comprehensive Income. Additionally, during the years ended

60

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

December 31, 2021 and 2020, we recognized $4,642,000 and $3,014,000, respectively, of government grant income in other income in our Consolidated Statements of Comprehensive Income.

The following is a summary of our SSNOI at Welltower's Share for the Seniors Housing Operating segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2022December 31, 2021$%December 31, 2022December 31, 2021$%
SSNOI(1)$184,716$155,608$29,10818.7%$610,724$548,872$61,85211.3%

(1) Relates to 654 properties for the QTD Pool and 514 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

During the year ended December 31, 2022, we recorded impairment charges of $13,146,000 related to one held for sale property in which the carrying value exceeded the estimated fair value less costs to sell. During the year ended December 31, 2021, we recorded impairment charges of $22,317,000 related to two held for use properties in which the carrying value exceeded the estimated fair value. Transaction costs related to asset acquisitions are capitalized as a component of the purchase price. The fluctuation in other expenses is primarily due to the timing of noncapitalizable transaction costs associated with acquisitions and operator transitions. Changes in the gain on sales of properties are related to the volume and timing of property sales and the sales prices.

Depreciation and amortization fluctuates as a result of acquisitions, disposition and transitions. To the extent we acquire or dispose of additional properties in the future, our provision for depreciation and amortization will change accordingly.

During the year ended December 31, 2022, we completed six Seniors Housing Operating construction projects representing $227,796,000 or $333,035 per unit. The following is a summary of our consolidated Seniors Housing Operating construction projects, excluding expansions, pending as of December 31, 2022 (dollars in thousands):

61

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

LocationUnits/BedsCommitmentBalanceEst. Completion(2)
New York72$42,669$31,7421Q23
Austin19639,50026,5551Q23 - 2Q23
Dallas11238,05418,5701Q23
Coventry7618,49414,1911Q23
Meadville, PA12813,99613,9961Q23
Dallas4713,9407,1181Q23
Charlotte32891,83668,8212Q23 - 3Q23
Austin18836,21531,1112Q23 - 3Q23
Barnstable Town, MA12031,76131,7612Q23
Hartford12822,36222,3622Q23
Hartford12220,94920,9492Q23
Boston16782,44636,4213Q23
Phoenix19954,75423,2823Q23 - 4Q23
Phoenix20453,40024,5763Q23 - 4Q23
Naples, FL18856,9109,3684Q23 - 1Q24
Tampa20652,4938,3764Q23 - 1Q24
Houston13032,07512,5044Q23 - 1Q24
Kansas City13421,27921,2794Q23
Cincinnati12218,2065,8081Q24
Dallas5216,5315,5111Q24 - 2Q24
Washington D.C.302173,54882,6062Q24
Boston160148,59072,1062Q24
Washington D.C.137126,20043,9662Q24
Killeen, TX256662659,1753Q24
3,774$1,272,473642,154
Austin(1)5,360
Austin(1)4,161
Baltimore(1)10,741
Boise, ID(1)35,557
Boise, ID(1)13,323
Boise, ID(1)5,889
Boston(1)10,416
Columbus, OH(1)15,742
Dallas(1)4,642
Detroit(1)1,931
Kansas City(1)15,869
Raleigh, NC(1)3,733
Sacramento(1)5,160
Sherman, TX(1)5,947
Toronto(1)49,702
Total$830,327
(1) Final units/beds, commitment amount and expected conversion date not yet known.
(2) Estimated completion ranges relate to projects to be delivered in phases.

Interest expense represents secured debt interest expense, which fluctuates based on the net effect and timing of assumptions, segment transitions, fluctuations in foreign currency rates, extinguishments and principal amortizations. The fluctuations in loss (gain) on extinguishment of debt is primarily attributable to the volume of extinguishments and terms of the related secured debt. The following is a summary of our Seniors Housing Operating segment property secured debt principal activity (dollars in thousands):

62

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Year EndedYear EndedYear Ended
December 31, 2022December 31, 2021December 31, 2020
Weighted Avg.Weighted Avg.Weighted Avg.
AmountInterest RateAmountInterest RateAmountInterest Rate
Beginning balance$1,599,5222.81%$1,706,1893.05%$2,115,0373.54%
Debt transferred in32,4784.79%—%—%
Debt issued113,1834.71%23,5692.83%62,0552.55%
Debt assumed288,5224.38%—%—%
Debt extinguished(227,910)4.34%(77,959)6.14%(441,208)2.18%
Principal payments(47,399)3.27%(50,603)3.03%(48,498)3.30%
Foreign currency(56,457)3.27%(1,674)2.67%18,8032.93%
Ending balance$1,701,9394.32%$1,599,5222.81%$1,706,1893.05%
Monthly averages$1,637,8103.43%$1,649,4852.88%$1,875,9103.19%

The majority of our Seniors Housing Operating properties are formed through partnership interests. Income from unconsolidated entities recognized during the year ended December 31, 2021 includes a gain recognized from the sale of a home health business owned by one of our unconsolidated entities. Net income attributable to noncontrolling interests represents our partners’ share of net income (loss) related to joint ventures. The decrease compared to the year ended December 31, 2021 relates primarily to our partners' share of reserves for previously recognized straight-line receivables.

Triple-net

The following is a summary of our results of operations for the Triple-net segment for the years presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20222021$%2020$%$%
Revenues:
Rental income$782,329$761,441$20,8883%$733,776$27,6654%$48,5537%
Interest income142,402124,54017,86214%62,62561,91599%79,777127%
Other income6,7764,6032,17347%4,903(300)-6%1,87338%
Total revenues931,507890,58440,9235%801,30489,28011%130,20316%
Property operating expenses44,48349,462(4,979)-10%53,183(3,721)-7%(8,700)-16%
NOI(1)887,024841,12245,9025%748,12193,00112%138,90319%
Other expenses:
Depreciation and amortization215,887220,699(4,812)-2%232,604(11,905)-5%(16,717)-7%
Interest expense9636,376(5,413)-85%9,477(3,101)-33%(8,514)-90%
Loss (gain) on derivatives and financial instruments, net8,334(7,333)15,667214%11,049(18,382)-166%(2,715)-25%
Loss (gain) on extinguishment of debt, net8080n/an/a80n/a
Provision for loan losses, net9,28910,339(1,050)-10%90,563(80,224)-89%(81,274)-90%
Impairment of assets3,59526,579(22,984)-86%34,867(8,288)-24%(31,272)-90%
Other expenses13,0434,1898,854211%22,923(18,734)-82%(9,880)-43%
251,191260,849(9,658)-4%401,483(140,634)-35%(150,292)-37%
Income from continuing operations before income taxes and other items635,833580,27355,56010%346,638233,63567%289,19583%
Income (loss) from unconsolidated entities34,49520,68713,80867%18,4622,22512%16,03387%
Gain (loss) on real estate dispositions, net16,648135,881(119,233)-88%64,28871,593111%(47,640)-74%
Income from continuing operations686,976736,841(49,865)-7%429,388307,45372%257,58860%
Net income686,976736,841(49,865)-7%429,388307,45372%257,58860%
Less: Net income attributable to noncontrolling interests28,95835,653(6,695)-19%39,985(4,332)-11%(11,027)-28%
Net income attributable to common stockholders$658,018$701,188$(43,170)-6%$389,403$311,78580%$268,61569%

(1) See Non-GAAP Financial Measures below.

Rental income has increased primarily due to the timing of the establishment of reserves for straight-line rent receivable balances relating to leases for which collection of substantially all contractual lease payments is no longer deemed probable. During the year ended December 31, 2021, we recorded reserves for previously recognized straight-line rent receivables of $49,241,000 which resulted in reduced rental income for the period. Offsetting the impact of straight-line changes, we have disposed of ten properties with a book value of $89,827,000 during 2022 and 51 properties with a book value of $486,369,000 during 2021.

63

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Certain of our leases contain annual rental escalators that are contingent upon changes in the Consumer Price Index and/or changes in the gross operating revenues of the tenant’s properties. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. If gross operating revenues at our facilities and/or the Consumer Price Index do not increase, a portion of our revenues may not continue to increase. For the year ended December 31, 2022, we had 50 leases with rental rate increasers ranging from 0.26% to 57.76% in our Triple-net portfolio. Our Triple-net operators are experiencing similar impacts on occupancy and operating costs due to the COVID-19 pandemic as described above with respect to our Seniors Housing Operating properties. Long-term/post-acute facilities have generally experienced a higher degree of occupancy declines, which in some cases impacted the ability of our Triple-net operators to make contractual rent payments to us. However, many of our Triple-net operators received funds under the CARES Act Paycheck Protection Program and Provider Relief Fund.

The increase to interest income during the year ended December 31, 2022 is primarily driven by interest recognized on senior loan financings of £540,000,000 made to affiliates of Safanad as part of the recapitalization of its investment in HC-One Group during the second quarter of 2021. Additionally, during the year ended December 31, 2021, we recognized a provision for loan losses under the current expected credit losses accounting standard, primarily related to the initial recognition of that loan. The provision for loan loss recognized during the year ended December 31, 2022 is primarily related to $11,714,000 of specific reserves recognized on a held to maturity debt security, offset by the release of previously established allowances for credit losses due to loan repayments.

The following is a summary of our SSNOI at Welltower's Share for the Triple-net segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2022December 31, 2021$%December 31, 2022December 31, 2021$%
SSNOI(1)$127,296$122,059$5,2374.3%$455,823$433,826$21,9975.1%

(1) Relates to 427 properties for the QTD Pool and 398 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

Depreciation and amortization fluctuate as a result of the acquisitions, dispositions and transitions of triple-net properties. To the extent we acquire or dispose of additional properties in the future, our provision for depreciation and amortization will change accordingly.

During the year ended December 31, 2022, we recorded impairment charges of $3,595,000 related to two held for use properties. During the year ended December 31, 2021, we recorded impairment charges of $26,579,000 related to four held for sale or sold properties and two held for use properties. Transaction costs related to asset acquisitions are capitalized as a component of purchase price. The fluctuation in other expenses is primarily due to noncapitalizable transaction costs from acquisitions and segment transitions. Changes in the gain on sales of properties are related to the volume and timing of property sales and the sales prices.

During the year ended December 31, 2022, there were no Triple-net construction projects completed; however, four projects transitioned out of the Triple-net segment and into the Seniors Housing Operating segment. Additionally, one project transitioned from consolidated to unconsolidated. The following is a summary of our consolidated Triple-net construction projects, excluding expansions, pending as of December 31, 2022 (dollars in thousands):

LocationUnits/BedsCommitmentBalanceEst. Completion
Raleigh191$154,142$120,0112Q23

During the years ended December 31, 2022 and 2021, loss (gain) on derivatives and financial instruments, net is primarily attributable to the mark-to-market of the equity warrants received as part of the Safanad/HC-One transaction that closed in the second quarter of 2021. In addition, the mark-to-market adjustment on our Genesis Healthcare available-for-sale investment is reflected in all periods.

Interest expense represents secured debt interest expense and related fees. The change in secured debt interest expense is due to the net effect and timing of assumptions, segment transitions, fluctuations in foreign currency rates, extinguishments and principal amortizations. The following is a summary of our Triple-net secured debt principal activity for the periods presented (dollars in thousands):

64

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Year EndedYear EndedYear Ended
December 31, 2022December 31, 2021December 31, 2020
Weighted Avg.Weighted Avg.Weighted Avg.
AmountInterest RateAmountInterest RateAmountInterest Rate
Beginning balance$72,5364.57%$123,6524.91%$306,0383.60%
Debt assumed39,57416.68%—%—%
Debt extinguished(39,574)16.68%(46,402)5.43%(176,875)2.03%
Debt transferred out(32,478)4.79%—%—%
Principal payments(879)4.37%(4,679)5.14%(4,376)5.16%
Foreign currency—%(35)5.43%(1,135)2.97%
Ending balance$39,1794.39%$72,5364.57%$123,6524.91%
Monthly averages$39,5844.39%$117,9664.90%$215,7963.85%

A portion of our Triple-net properties were formed through partnerships. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. The increase in income from unconsolidated entities during the year ended December 31, 2022 is primarily related to the write off of a right of use asset and related lease liability on an unconsolidated joint venture that was restructured during the year. Net income attributable to noncontrolling interests represents our partners’ share of net income relating to those partnerships where we are the controlling partner. The decrease in net income attributable to noncontrolling interests for the year ended December 31, 2022 compared to 2021 is related to the increase in ownership in existing Triple-net joint ventures.

Outpatient Medical

The following is a summary of our results of operations for the Outpatient Medical segment for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20222021$%2020$%$%
Revenues:
Rental income$669,457$613,254$56,2039%$709,584$(96,330)-14%$(40,127)-6%
Interest income3028,792(8,490)-97%5,9132,87949%(5,611)-95%
Other income8,99813,243(4,245)-32%4,5228,721193%4,47699%
Total revenues678,757635,28943,4687%720,019(84,730)-12%(41,262)-6%
Property operating expenses205,997186,93919,05810%214,948(28,009)-13%(8,951)-4%
NOI(1)472,760448,35024,4105%505,071(56,721)-11%(32,311)-6%
Other expenses:
Depreciation and amortization239,681223,30216,3797%261,371(38,069)-15%(21,690)-8%
Interest expense18,07817,5065723%17,579(73)%4993%
Loss (gain) on extinguishment of debt, net15(4)19475%1,046(1,050)-100%(1,031)-99%
Provision for loan losses, net(8)(3,463)3,455100%3,202(6,665)-208%(3,210)-100%
Impairment of assets7612,211(1,450)-66%2,211n/a761n/a
Other expenses2,5372,523141%8,218(5,695)-69%(5,681)-69%
261,064242,07518,9898%291,416(49,341)-17%(30,352)-10%
Income from continuing operations before income taxes and other item211,696206,2755,4213%213,655(7,380)-3%(1,959)-1%
Income (loss) from unconsolidated entities(2,467)(4,395)1,92844%7,312(11,707)-160%(9,779)-134%
Gain (loss) on real estate dispositions, net(6,399)93,348(99,747)-107%695,918(602,570)-87%(702,317)-101%
Income from continuing operations202,830295,228(92,398)-31%916,885(621,657)-68%(714,055)-78%
Net income (loss)202,830295,228(92,398)-31%916,885(621,657)-68%(714,055)-78%
Less: Net income (loss) attributable to noncontrolling interests7,1804,9162,26446%(278)5,194n/a7,458n/a
Net income (loss) attributable to common stockholders$195,650$290,312$(94,662)-33%$917,163$(626,851)-68%$(721,513)-79%

(1) See Non-GAAP Financial Measures below.

Rental income has increased due primarily to acquisitions and construction conversions that occurred during 2021 and 2022. Certain of our leases contain annual rental escalators that are contingent upon changes in the Consumer Price Index. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. If the Consumer Price Index does not increase, a portion of our revenues may not continue to increase. Our leases could renew above or below current rental rates, resulting in an increase or decrease in rental income. For the year ended December 31, 2022, our consolidated Outpatient Medical portfolio signed 435,000 square feet of new leases and 1,826,000 square feet of renewals. The weighted-average term of these leases was seven years, with a rate of $38.19 per square foot and tenant improvement and lease commission costs of $26.77 per square foot. Substantially all of these leases contain an annual fixed or contingent escalation rent structure ranging from 1.0% to 7.0%.

65

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The decrease in interest income for the year ended December 31, 2022 is due primarily to a $178,207,000 first mortgage initiated in August 2020, which was subsequently repaid in full in June of 2021, resulting in the reversal of the previously established allowance for credit losses.

The fluctuation in property operating expenses and depreciation and amortization are primarily attributable to acquisitions and construction conversions that occurred during 2021 and 2022. To the extent that we acquire or dispose of additional properties in the future, these amounts will change accordingly.

The following is a summary of our SSNOI at Welltower Share for the Outpatient Medical segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2022December 31, 2021$%December 31, 2022December 31, 2021$%
SSNOI(1)$107,867$105,260$2,6072.5%$403,520$395,379$8,1412.1%

(1) Relates to 361 properties for the QTD Pool and 349 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

During the year ended December 31, 2022, we recognized an impairment charge of $761,000 related to one held for use property. During the year ended December 31, 2021, we recognized an impairment charge of $2,211,000 related to one held for sale property. Transaction costs related to asset acquisitions are capitalized as a component of purchase price. The fluctuation in other expenses is primarily due to noncapitalizable transaction costs. Changes in gains/losses on sales of properties are related to volume of property sales and the sales prices.

During the year ended December 31, 2022, we completed two Outpatient Medical construction projects representing $44,778,000 or $383 per square foot. The following is a summary of our consolidated Outpatient Medical construction projects, excluding expansions, pending as of December 31, 2022 (dollars in thousands):

LocationSquare FeetCommitmentBalanceEst. Completion
Houston16,835$9,935$5,7961Q23
Beaumont-Port Arthur, TX33,00011,8225,5252Q23
Houston16,8309,0774,3282Q23
66,665$30,83415,649
Charlotte, NC(1)33,376
$49,025
(1) Final square feet, commitment amount and expected conversion date not yet known.

Total interest expense represents secured debt interest expense. The change in secured debt interest expense is primarily due to the net effect and timing of assumptions, extinguishments and principal amortizations. The following is a summary of our Outpatient Medical secured debt principal activity for the periods presented (dollars in thousands):

Year EndedYear EndedYear Ended
December 31, 2022December 31, 2021December 31, 2020
Weighted Avg.Weighted Avg.Weighted Avg.
AmountInterest RateAmountInterest RateAmountInterest Rate
Beginning balance$530,2543.49%$548,2293.55%$572,2673.97%
Debt extinguished(131,582)4.26%(7,670)5.64%(14,205)5.34%
Principal payments(9,836)4.45%(10,305)4.43%(9,833)4.60%
Ending balance$388,8364.38%$530,2543.49%$548,2293.55%
Monthly averages$485,1613.89%$540,9473.52%$562,0173.72%

A portion of our Outpatient Medical properties were formed through partnerships. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. Net income attributable to noncontrolling interests represents our partners’ share of net income or loss relating to those partnerships where we are the controlling partner.

66

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Non-Segment/Corporate

The following is a summary of our results of operations for the Non-Segment/Corporate activities for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20222021$%2020$%$%
Revenues:
Other income$4,934$2,992$1,94265%$2,781$2118%$2,15377%
Total revenues4,9342,9921,94265%2,7812118%2,15377%
Property operating expenses16,2458,8177,42884%3,3815,436161%12,864380%
NOI(1)(11,311)(5,825)(5,486)-94%(600)(5,225)-871%(10,711)n/a
Other expenses:
Interest expense475,645426,64449,00111%432,431(5,787)-1%43,21410%
General and administrative expenses150,390126,72723,66319%128,394(1,667)-1%21,99617%
Loss (gain) on extinguishments of debt, net19952,506(52,307)-100%33,34419,16257%(33,145)-99%
Other expenses20,0647,89512,169154%24,929(17,034)-68%(4,865)-20%
Total expenses646,298613,77232,5265%619,098(5,326)-1%27,2004%
Loss from continuing operations before income taxes and other items(657,609)(619,597)(38,012)-6%(619,698)101%(37,911)-6%
Income tax (expense) benefit(7,247)(8,713)1,46617%(9,968)1,25513%2,72127%
Loss from continuing operations(664,856)(628,310)(36,546)-6%(629,666)1,356%(35,190)-6%
Net loss attributable to common stockholders$(664,856)$(628,310)$(36,546)-6%$(629,666)$1,356%$(35,190)-6%

(1) See Non-GAAP Financial Measures below.

Property operating expenses represent insurance costs related to our captive insurance company formed as of July 1, 2020, which acts as a direct insurer of property level insurance coverage for our portfolio.

The following is a summary of our Non-Segment/Corporate interest expense for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20222021$%2020$%$%
Senior unsecured notes$436,185$401,247$34,9389%$400,014$1,233%$36,1719%
Unsecured credit facility and commercial paper program19,5766,75912,817190%15,313(8,554)-56%4,26328%
Loan expense19,88418,6381,2467%17,1041,5349%2,78016%
Totals$475,645$426,644$49,00111%$432,431$(5,787)-1%$43,21410%

The change in interest expense on senior unsecured notes is due to the net effect of issuances and extinguishments, as well as the movement in foreign exchange rates and related hedge activity. Please refer to Note 11 to the consolidated financial statements for additional information. The change in interest expense on our unsecured revolving credit facility and commercial paper program is due primarily to the net effect and timing of draws, paydowns and variable interest rate changes. Please refer to Note 10 of our consolidated financial statements for additional information. Loan expenses represent the amortization of costs incurred in connection with senior unsecured notes issuances. The loss on extinguishment recognized during the year ended December 31, 2021 is due primarily to the early extinguishment of $339,128,000 of our 3.75% senior unsecured notes due March 2023 and $334,624,000 of our 3.95% senior unsecured notes due September 2023.

General and administrative expenses as a percentage of consolidated revenues for the years ended December 31, 2022, 2021 and 2020 were 2.57%, 2.67% and 2.79%, respectively. Other expenses includes non-capitalizable legal expenses, including related to our umbrella partnership REIT reorganization during 2022. The provision for income taxes primarily relates to state taxes, foreign taxes and taxes based on income generated by entities that are structured as TRSs.

Other

Non-GAAP Financial Measures

We believe that net income and net income attributable to common stockholders, as defined by U.S. GAAP, are the most appropriate earnings measurements. However, we consider FFO, NOI, SSNOI, EBITDA and Adjusted EBITDA to be useful supplemental measures of our operating performance. Historical cost accounting for real estate assets in accordance with U.S. GAAP implicitly assumes that the value of real estate assets diminishes predictably over time as evidenced by the provision for depreciation. However, since real estate values have historically risen or fallen with market conditions, many industry investors and analysts have considered presentations of operating results for real estate companies that use historical cost accounting to be insufficient. In response, the National Association of Real Estate Investment Trusts (“NAREIT”) created funds from operations attributable to common stockholders (“FFO”) as a supplemental measure of operating performance for REITs that

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

excludes historical cost depreciation from net income. FFO, as defined by NAREIT, means NICS, computed in accordance with U.S. GAAP, excluding gains (or losses) from sales of real estate and impairment of depreciable assets, plus depreciation and amortization, and after adjustments for unconsolidated entities and noncontrolling interests.

NOI is used to evaluate the operating performance of our properties. We define NOI as total revenues, including tenant reimbursements, less property operating expenses. Property operating expenses represent costs associated with managing, maintaining and servicing tenants for our properties. These expenses include, but are not limited to, property-related payroll and benefits, property management fees paid to operators, marketing, housekeeping, food service, maintenance, utilities, property taxes and insurance. General and administrative expenses represent general overhead costs that are unrelated to property operations and unallocable to the properties. These expenses include, but are not limited to, payroll and benefits related to corporate employees, professional services, office expenses and depreciation of corporate fixed assets. Same store NOI (“SSNOI”) is used to evaluate the operating performance of our properties using a consistent population which controls for changes in the composition of our portfolio. We believe the drivers of property level NOI for both consolidated properties and unconsolidated properties are generally the same and therefore, we evaluate SSNOI based on our ownership interest in each property ("Welltower Share"). To arrive at Welltower's Share, NOI is adjusted by adding our minority ownership share related to unconsolidated properties and by subtracting the minority partners' noncontrolling ownership interests for consolidated properties. We do not control investments in unconsolidated properties and while we consider disclosures at Welltower Share to be useful, they may not accurately depict the legal and economic implications of our joint venture arrangements and should be used with caution. As used herein, same store is generally defined as those revenue-generating properties in the portfolio for the relevant year-over-year reporting periods. Acquisitions and development conversions are included in SSNOI five full quarters or eight full quarters after acquisition or being placed into service for the QTD Pool and the YTD Pool, respectively. Land parcels, loans and sub-leases, as well as any properties sold or classified as held for sale during the respective periods are excluded from SSNOI. Redeveloped properties (including major refurbishments of a Seniors Housing Operating property where 20% or more of units are simultaneously taken out of commission for 30 days or more or Outpatient Medical properties undergoing a change in intended use) are excluded from SSNOI until five full quarters or eight full quarters post completion of the redevelopment for the QTD Pool and YTD Pool, respectively. Properties undergoing operator transitions and/or segment transitions are also excluded from SSNOI until five full quarters or eight full quarters post completion of the transition for the QTD Pool and YTD Pool, respectively. In addition, properties significantly impacted by force majeure, acts of God, or other extraordinary adverse events are excluded from SSNOI until five full quarters or eight full quarters after the properties are placed back into service for the QTD Pool and YTD Pool, respectively. SSNOI excludes non-cash NOI and includes adjustments to present consistent ownership percentages and to translate Canadian properties and U.K. properties using a consistent exchange rate. We believe NOI and SSNOI provide investors relevant and useful information because they measure the operating performance of our properties at the property level on an unleveraged basis. We use NOI and SSNOI to make decisions about resource allocations and to assess the property level performance of our properties.

EBITDA is defined as earnings (net income) before interest, taxes, depreciation and amortization. Adjusted EBITDA is defined as EBITDA excluding unconsolidated entities and including adjustments for stock-based compensation expense, provision for loan losses, gains/losses on extinguishment of debt, gains/loss/impairments on properties, gains/losses on derivatives and financial instruments, other expenses, other impairment charges and other adjustments as deemed appropriate. We believe that EBITDA and Adjusted EBITDA, along with net income, are important supplemental measures because they provide additional information to assess and evaluate the performance of our operations. We primarily use these measures to determine our interest coverage ratio, which represents EBITDA and Adjusted EBITDA divided by total interest, and our fixed charge coverage ratio, which represents EBITDA and Adjusted EBITDA divided by fixed charges. Fixed charges include total interest and secured debt principal amortization. Covenants in our unsecured senior notes and primary credit facility contain financial ratios based on a definition of EBITDA and Adjusted EBITDA that is specific to those agreements. Our leverage ratios are defined as the proportion of net debt to total capitalization and include book capitalization, undepreciated book capitalization and market capitalization. Book capitalization represents the sum of net debt (defined as total long-term debt, excluding operating lease liabilities, less cash and cash equivalents and restricted cash), total equity and redeemable noncontrolling interests. Undepreciated book capitalization represents book capitalization adjusted for accumulated depreciation and amortization. Market capitalization represents book capitalization adjusted for the fair market value of our common stock.

Our supplemental reporting measures and similarly entitled financial measures are widely used by investors, equity and debt analysts and rating agencies in the valuation, comparison, rating and investment recommendations of companies. Management uses these financial measures to facilitate internal and external comparisons to our historical operating results and in making operating decisions. Additionally, these measures are utilized by the Board of Directors to evaluate management. None of our supplemental measures represent net income or cash flow provided from operating activities as determined in accordance with U.S. GAAP and should not be considered as alternative measures of profitability or liquidity. Finally, the supplemental measures, as defined by us, may not be comparable to similarly entitled items reported by other real estate investment trusts or other companies.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The table below reflects the reconciliation of FFO to NICS, the most directly comparable U.S. GAAP measure, for the periods presented. Noncontrolling interest and unconsolidated entity amounts represent adjustments to reflect our share of depreciation and amortization, gains/loss on real estate dispositions and impairment of assets. Amounts are in thousands except for per share data.

Year Ended December 31,
FFO Reconciliation:202220212020
Net income attributable to common stockholders$141,214$336,138$978,844
Depreciation and amortization1,310,3681,037,5661,038,437
Impairment of assets17,50251,107135,608
Loss (gain) on real estate dispositions, net(16,043)(235,375)(1,088,455)
Noncontrolling interests(56,529)(54,190)(23,968)
Unconsolidated entities81,56085,47662,096
Funds from operations attributable to common stockholders$1,478,072$1,220,722$1,102,562
Average diluted shares outstanding:465,158426,841417,387
Per diluted share data:
Net income attributable to common stockholders(1)$0.30$0.78$2.33
Funds from operations attributable to common stockholders$3.18$2.86$2.64
(1) Includes adjustment to the numerator for income (loss) attributable to OP unitholders.

The following tables reflect the reconciliation of consolidated NOI to net income, the most directly comparable U.S. GAAP measure, for the years presented. Dollar amounts are in thousands.

Year Ended December 31,
NOI Reconciliation:202220212020
Net income (loss)$160,568$374,479$1,038,852
Loss (gain) on real estate dispositions, net(16,043)(235,375)(1,088,455)
Loss (income) from unconsolidated entities21,29022,9338,083
Income tax expense (benefit)7,2478,7139,968
Other expenses101,67041,73970,335
Impairment of assets17,50251,107135,608
Provision for loan losses, net10,3207,27094,436
Loss (gain) on extinguishment of debt, net68049,87447,049
Loss (gain) on derivatives and financial instruments, net8,334(7,333)11,049
General and administrative expenses150,390126,727128,394
Depreciation and amortization1,310,3681,037,5661,038,437
Interest expense529,519489,853514,388
Consolidated net operating income (NOI)$2,301,845$1,967,553$2,008,144
NOI by segment:
Seniors Housing Operating$953,372$683,906$755,552
Triple-net887,024841,122748,121
Outpatient Medical472,760448,350505,071
Non-segment/corporate(11,311)(5,825)(600)
Total NOI$2,301,845$1,967,553$2,008,144

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Quarterly NOI by Segment:
(in thousands)Three Months EndedYear Ended
March 31,June 30,September 30,December 31,December 31,
2022202120222021202220212022202120222021
Seniors Housing Operating:
Total revenues$996,612$726,402$1,071,210$742,549$1,072,600$839,519$1,104,995$904,780$4,245,417$3,213,250
Property operating expenses789,928555,968789,299582,361841,914666,610870,904724,4053,292,0452,529,344
Consolidated NOI$206,684$170,434$281,911$160,188$230,686$172,909$234,091$180,375$953,372$683,906
Triple-net:
Total revenues$235,163$168,482$234,360$238,941$228,819$239,985$233,165$243,176$931,507$890,584
Property operating expenses11,21112,84111,49112,62711,49511,66410,28612,33044,48349,462
Consolidated NOI$223,952$155,641$222,869$226,314$217,324$228,321$222,879$230,846$887,024$841,122
Outpatient Medical:
Total revenues$163,323$156,223$166,322$159,072$172,178$159,503$176,934$160,491$678,757$635,289
Property operating expenses49,91546,86350,64845,49552,92148,07252,51346,509205,997186,939
Consolidated NOI$113,408$109,360$115,674$113,577$119,257$111,431$124,421$113,982$472,760$448,350
Corporate:
Total revenues$606$955$644$430$247$790$3,437$817$4,934$2,992
Property operating expenses2,6151,6542,6452,1745,8503,0545,1351,93516,2458,817
Consolidated NOI$(2,009)$(699)$(2,001)$(1,744)$(5,603)$(2,264)$(1,698)$(1,118)$(11,311)$(5,825)

The following is a reconciliation of the properties included in our QTD Pool and YTD Pool for SSNOI:

QTD PoolYTD Pool
SSNOI Property Reconciliations:Seniors Housing OperatingTriple-netOutpatient MedicalTotalSeniors Housing OperatingTriple-netOutpatient MedicalTotal
Consolidated properties8505703231,7438505703231,743
Unconsolidated properties10439792221043979222
Total properties9546094021,9659546094021,965
Recent acquisitions/development conversions(1)(114)(11)(24)(149)(254)(40)(36)(330)
Under development(40)(5)(45)(40)(5)(45)
Under redevelopment(2)(4)(3)(4)(11)(4)(3)(4)(11)
Current held for sale(3)(7)(1)(11)(3)(7)(1)(11)
Land parcels, loans and subleases(24)(8)(7)(39)(24)(8)(7)(39)
Transitions(3)(108)(150)(258)(108)(150)(258)
Other(4)(7)(3)(10)(7)(3)(10)
Same store properties6544273611,4425143983491,261
(1) Acquisitions and development conversions will enter the QTD Pool and YTD Pool five full quarters and eight full quarters after acquisition or certificate of occupancy, respectively.
(2) Redevelopment properties will enter the QTD Pool and YTD Pool after five full quarters and eight full quarters of operations post redevelopment completion, respectively.
(3) Transitioned properties will enter the QTD Pool and YTD Pool after five full quarters and eight full quarters of operations with the new operator in place or under the new structure, respectively.
(4) Represents properties that are either closed or being closed.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a reconciliation of our consolidated NOI to same store NOI for the periods presented for the respective pools. Dollar amounts are in thousands.

QTD PoolYTD Pool
Three Months EndedTwelve Months Ended
SSNOI Reconciliations:December 31, 2022December 31, 2021December 31, 2022December 31, 2021
Seniors Housing Operating:
Consolidated NOI$234,091$180,375$953,372$683,906
NOI attributable to unconsolidated investments11,29110,71347,19044,470
NOI attributable to noncontrolling interests(16,718)(12,125)(122,874)(65,747)
Non-cash NOI attributable to same store properties(196)(662)(747)10,878
NOI attributable to non-same store properties(46,511)(22,024)(270,363)(121,779)
Currency and ownership adjustments (1)2,759(669)4,146(2,856)
SSNOI at Welltower Share184,716155,608610,724548,872
Triple-net:
Consolidated NOI222,879230,846887,024841,122
NOI attributable to unconsolidated investments8,9474,89329,51619,559
NOI attributable to noncontrolling interests(9,555)(13,600)(41,099)(48,892)
Non-cash NOI attributable to same store properties(11,592)(8,310)(37,190)(27,000)
NOI attributable to non-same store properties(86,076)(92,708)(389,905)(352,792)
Currency and ownership adjustments (1)2,6939387,4771,829
SSNOI at Welltower Share127,296122,059455,823433,826
Outpatient Medical:
Consolidated NOI124,421113,982472,760448,350
NOI attributable to unconsolidated investments4,7124,68219,23318,998
NOI attributable to noncontrolling interests(5,576)(4,896)(22,089)(18,645)
Non-cash NOI attributable to same store properties(4,287)(3,523)(10,323)(10,384)
NOI attributable to non-same store properties(11,250)(5,298)(56,001)(42,089)
Currency and ownership adjustments (1)(153)313(60)(851)
SSNOI at Welltower Share107,867105,260403,520395,379
SSNOI at Welltower Share:
Seniors Housing Operating184,716155,608610,724548,872
Triple-net127,296122,059455,823433,826
Outpatient Medical107,867105,260403,520395,379
Total$419,879$382,927$1,470,067$1,378,077
(1) Includes adjustments to reflect consistent property ownership percentages, to translate Canadian properties at a USD/CAD rate of 1.2738 and to translate U.K. properties at a GBP/USD rate of 1.3501.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The table below reflects the reconciliation of EBITDA and Adjusted EBITDA to net income, the most directly comparable U.S. GAAP measure, for the periods presented. Dollars are in thousands.

Year Ended December 31,
Adjusted EBITDA Reconciliation:202220212020
Net income (loss)$160,568$374,479$1,038,852
Interest expense529,519489,853514,388
Income tax expense (benefit)7,2478,7139,968
Depreciation and amortization1,310,3681,037,5661,038,437
EBITDA2,007,7021,910,6112,601,645
Loss (income) from unconsolidated entities21,29022,9338,083
Stock-based compensation expense26,02716,93322,154
Loss (gain) on extinguishment of debt, net68049,87447,049
Loss (gain) on real estate dispositions, net(16,043)(235,375)(1,088,455)
Impairment of assets17,50251,107135,608
Provision for loan losses, net10,3207,27094,436
Loss (gain) on derivatives and financial instruments, net8,334(7,333)11,049
Other expenses101,67041,73970,335
Lease termination and leasehold interest adjustment (1)(64,854)760
Casualty losses, net of recoveries10,3915,786
Other impairment, net (2)(620)49,241146,508
Adjusted EBITDA$2,122,399$1,913,546$2,048,412
Adjusted Interest Coverage Ratio:
Interest expense$529,519$489,853$514,388
Capitalized interest30,49119,35217,472
Non-cash interest expense(21,754)(17,506)(15,751)
Total interest538,256491,699516,109
EBITDA$2,007,702$1,910,611$2,601,645
Interest coverage ratio3.73x3.89x5.04x
Adjusted EBITDA$2,122,399$1,913,546$2,048,412
Adjusted interest coverage ratio3.94x3.89x3.97x
Adjusted Fixed Charge Coverage Ratio:
Total interest$538,256$491,699$516,109
Secured debt principal payments58,11465,58762,707
Total fixed charges596,370557,286578,816
EBITDA$2,007,702$1,910,611$2,601,645
Fixed charge coverage ratio3.37x3.43x4.49x
Adjusted EBITDA$2,122,399$1,913,546$2,048,412
Adjusted fixed charge coverage ratio3.56x3.43x3.54x

(1) Represents revenues and property operating expenses associated with a leasehold portfolio interest relating to 26 properties assumed by a wholly-owned affiliate in conjunction with the Holiday Retirement transaction. Subsequent to the initial transaction, we purchased eight of the leased properties and one of the properties was sold by the landlord and removed from the lease. No rent was paid in excess of net cash flow relating to the leasehold properties and therefore, the net impact has been excluded from Adjusted EBITDA. Additionally, in conjunction with the lease termination, during the year ended December 31, 2022, we recognized $58,621,000 in other income from the derecognition of the right of use asset and related lease liability which has also been excluded from Adjusted EBITDA.

(2) Represents the changes in the reserve for straight-line rent receivables balances relating to leases placed on cash recognition.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Our leverage ratios include book capitalization, undepreciated book capitalization and market capitalization. Book capitalization represents the sum of net debt (defined as total long-term debt less cash and cash equivalents and restricted cash), total equity and redeemable noncontrolling interests. Undepreciated book capitalization represents book capitalization adjusted for accumulated depreciation and amortization. Market capitalization represents book capitalization adjusted for the fair market value of our common stock. Our leverage ratios are defined as the proportion of net debt to total capitalization. The table below reflects the reconciliation of our leverage ratios to our balance sheets for the periods presented. Amounts are in thousands, except share price.

Year Ended December 31,
202220212020
Book capitalization:
Unsecured credit facility and commercial paper$$324,935$
Long-term debt obligations(1)14,661,55213,917,70213,905,822
Cash and cash equivalents and restricted cash(722,292)(346,755)(2,021,043)
Total net debt13,939,26013,895,88211,884,779
Total equity and noncontrolling interests(2)21,393,99618,997,87317,225,062
Book capitalization$35,333,256$32,893,755$29,109,841
Net debt to book capitalization ratio39.5%42.2%40.8%
Undepreciated book capitalization:
Total net debt$13,939,260$13,895,882$11,884,779
Accumulated depreciation and amortization8,075,7336,910,1146,104,297
Total equity and noncontrolling interests(2)21,393,99618,997,87317,225,062
Undepreciated book capitalization$43,408,989$39,803,869$35,214,138
Net debt to undepreciated book capitalization ratio32.1%34.9%33.8%
Market capitalization:
Common shares outstanding490,509447,239417,401
Period end share price$65.55$85.77$64.62
Common equity market capitalization$32,152,865$38,359,689$26,972,453
Total net debt13,939,26013,895,88211,884,779
Noncontrolling interests(2)1,099,1821,361,8721,252,343
Market capitalization:$47,191,307$53,617,443$40,109,575
Net debt to market capitalization ratio29.5%25.9%29.6%

(1) Amounts include senior unsecured notes, secured debt and lease liabilities related to finance leases, as reflected on our Consolidated Balance Sheets. Operating lease liabilities related to the ASC 842 adoption are excluded.

(2) Includes amounts attributable to both redeemable noncontrolling interests and noncontrolling interests as reflected on our Consolidated Balance Sheets.

Critical Accounting Policies & Estimates

Our consolidated financial statements are prepared in accordance with U.S. GAAP, which requires us to make estimates and assumptions. Management considers an accounting estimate or assumption critical if:

•the nature of the estimates or assumptions is material due to the levels of subjectivity and judgment necessary to account for highly uncertain matters or the susceptibility of such matters to change; and

•the impact of the estimates and assumptions on financial condition or operating performance is material.

Management has discussed the development and selection of its critical accounting policies and estimates with the Audit Committee of the Board of Directors. Management believes the current assumptions and other considerations used to estimate amounts reflected in our consolidated financial statements are appropriate and are not reasonably likely to change in the future. However, since these estimates require assumptions to be made that were uncertain at the time the estimate was made, they bear the risk of change. If actual experience differs from the assumptions and other considerations used in estimating amounts reflected in our consolidated financial statements, the resulting changes could have a material adverse effect on our consolidated results of operations, liquidity and/or financial condition. Please refer to Note 2 to our consolidated financial statements for further information on significant accounting policies that impact us and for the impact of new accounting standards, including accounting pronouncements that were issued but not yet adopted by us.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following table presents information about our critical accounting policies and estimates:

Nature of Critical Accounting EstimateAssumptions/Approach Used
Impairment of Real Property Assessing impairment of real property involves subjectivity in determining if indicators of impairment are present and in estimating the future undiscounted cash flows or estimated fair value of an asset. In estimating the undiscounted cash flows or fair value, key assumptions that would be made are the estimation of future rental revenues, operating expenses, capitalization rates and the ability and intent to hold the respective asset, all of which are affected by our expectations of future market or economic conditions. These estimates can have a significant impact on the undiscounted cash flows or estimated fair value of an asset.Quarterly, we evaluate our real estate investments on a property by property basis to determine if there are indicators of impairment. These indicators may include expected operational performance, the tenant's ability to make rent payments, a decision to dispose of an asset before the end of its estimated useful life and changes in the market that may permanently reduce the value of the property. If indicators of impairment exist, an undiscounted cash flow analysis will be prepared to determine if the value of the real property will be recoverable. If the real property will not be recoverable, the carrying value of the property is reduce to its estimated fair value and an impairment charge is recognized for the difference between the carrying value and the fair value. This analysis requires us to use judgment in determining whether indicators of impairment exist and to estimate the expected future undiscounted cash flows or estimated fair values of the property. Properties that meet the held for sale criteria are recorded at the lesser of the fair value less costs to sell or carrying value. At December 31, 2022, our net real property owned was approximately $32,925,033,000. During the year ended December 31, 2022, we recorded impairment charges of $13,146,000 related to one Seniors Housing Operating property which was classified as held for sale for which the carrying values exceeded the fair values less costs to sell. Additionally, we recorded $4,356,000 of impairment charges related to two Triple-net properties and one Outpatient Medical property that were held for use in which the carrying values exceeded the estimated fair values.
Real Estate Acquisitions We believe that substantially all of our real estate acquisitions are considered asset acquisitions for which we record the related real estate acquired (tangible assets and identifiable intangible assets and liabilities) at cost on a relative fair value basis. Liabilities assumed and any associated noncontrolling interests are reflected at fair value. Tangible assets consist primarily of land, building and improvements. Identifiable intangible assets and liabilities primarily consist of the above or below market component of in-place leases and the value of in-place leases. The total amount of other intangible assets acquired is further allocated to in-place lease values and customer relationship values based on management's evaluation of the specific characteristics of each tenant's lease and our overall relationship with respect to that tenant.The allocation of the purchase price to the related real estate acquired (tangible assets and intangible assets and liabilities) involves subjectivity as such allocations are based on a relative fair value analysis. In determining the fair values that drive such analysis, we estimate the fair value of each component of the real estate acquired which generally includes land, buildings and improvements, the above or below market component of in-place leases and the value of in-place leases. Significant assumptions used to determine such fair values include comparable land sales, capitalization rates, discount rates, market rental rates and property operating data, all of which can be impacted by expectations about future market or economic conditions. Our estimates of the values of these components affect the amount of depreciation and amortization we record over the estimated useful life of the property or the term of the lease. During the year ended December 31, 2022, we completed $2,306,020,000 of real estate acquisitions. These transactions were accounted for as asset acquisitions and the purchase price of each was allocated based on the relative fair values of the assets acquired and liabilities assumed.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Nature of Critical Accounting EstimateAssumptions/Approach Used
Principles of Consolidation The consolidated financial statements include our accounts, the accounts of our wholly-owned subsidiaries, and the accounts of joint venture entities in which we own a majority voting interest with the ability to control operations and where no substantive participating rights or substantive kick out rights have been granted to the noncontrolling interests. In addition, we consolidate those entities deemed to be variable interest entities (“VIEs”) in which we are determined to be the primary beneficiary. All material intercompany transactions and balances have been eliminated in consolidation.We make judgments about which entities are VIEs based on an assessment of whether (i) the equity investors as a group, if any, do not have a controlling financial interest, or (ii) the equity investment at risk is insufficient to finance that entity’s activities without additional subordinated financial support. We make judgments with respect to our level of influence or control of an entity and whether we are (or are not) the primary beneficiary of a VIE. Consideration of various factors include, but is not limited to, our ability to direct the activities that most significantly impact the entity's economic performance, our form of ownership interest, our representation on the entity's governing body, the size and seniority of our investment, our ability and the rights of other investors to participate in policy making decisions, replace the manager and/or liquidate the entity, if applicable. Our ability to correctly assess our influence or control over an entity at inception of our involvement or on a continuous basis when determining the primary beneficiary of a VIE affects the presentation of these entities in our consolidated financial statements. If we perform a primary beneficiary analysis at a date other than at inception of the VIE, our assumptions may be different and may result in the identification of a different primary beneficiary.
Allowance for Credit Losses on Loans Receivable The allowance for credit losses is maintained at a level believed adequate to absorb potential losses in our loans receivable. The determination of the credit allowance is based on a quarterly evaluation of all outstanding loans, including general economic conditions and estimated collectability of loan payments.The determination of the allowance for credit losses is based on a quarterly evaluation of all outstanding loans, including general economic conditions and estimated collectability of loan payments. We evaluate the collectability of our loans receivable based on a combination of factors, including, but not limited to, payment status, historical loan charge-offs, financial strength of the borrower and guarantors, and nature, extent and value of the underlying collateral. A loan is considered to have deteriorated credit quality when, based on current information and events, it is probable that we will be unable to collect all amounts due as scheduled according to the contractual terms of the loan agreement. For those loans we identified as having deteriorated credit quality, we determine the amount of credit loss on an individual basis. Placement on non-accrual status may be required. Consistent with this definition, all loans on non-accrual are deemed to have deteriorated credit quality. To the extent circumstances improve and the risk of collectability is diminished, we may return these loans to income accrual status. While a loan is on non-accrual status, any cash receipts are applied against the outstanding principal balance. For the remaining loans, we assess credit loss on a collective pool basis and use our historical loss experience for similar loans to determine the reserve for credit losses. During the year ended December 31, 2022, we recognized provision for loan losses of $10,320,000, which includes a specific reserve for a Triple-net held to maturity debt security, offset by changes in the reserve based on our historical loss experience.

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FY 2021 10-K MD&A

SEC filing source: 0000766704-22-000013.

Extracted structurally from real Item 7 body heading to real Item 7A/8 boundary. Confidence: high. Filing date: 2022-02-16. Report date: 2021-12-31.

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

EXECUTIVE SUMMARY
Company Overview46
Business Strategy47
Key Transactions48
Key Performance Indicators, Trends and Uncertainties48
Corporate Governance50
LIQUIDITY AND CAPITAL RESOURCES
Sources and Uses of Cash50
Off-Balance Sheet Arrangements51
Contractual Obligations51
Capital Structure52
RESULTS OF OPERATIONS
Summary53
Seniors Housing Operating54
Triple-net57
Outpatient Medical59
Non-Segment/Corporate61
OTHER
Non-GAAP Financial Measures61
Critical Accounting Policies and Estimates67

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following discussion and analysis is based primarily on the consolidated financial statements of Welltower Inc. presented in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for the periods presented and should be read together with the notes thereto contained in this Annual Report on Form 10-K. Other important factors are identified in “Item 1 — Business” and “Item 1A — Risk Factors” above.

Executive Summary

Company Overview

Welltower Inc. (NYSE:WELL), an S&P 500 company headquartered in Toledo, Ohio, is driving the transformation of health care infrastructure. The Company invests with leading seniors housing operators, post-acute providers and health systems to fund the real estate and infrastructure needed to scale innovative care delivery models and improve people’s wellness and overall health care experience. Welltower™, a real estate investment trust (“REIT”), owns interests in properties concentrated in major, high-growth markets in the United States (U.S.), Canada and the United Kingdom (U.K.), consisting of seniors housing and post-acute communities and outpatient medical properties.

The following table summarizes our consolidated portfolio for the year ended December 31, 2021 (dollars in thousands):

Percentage ofNumber of
Type of PropertyNOI(1)NOIProperties
Seniors Housing Operating$683,90634.7%721
Triple-net841,12242.6%624
Outpatient Medical448,35022.7%306
Totals$1,973,378100.0%1,651

(1) Represents consolidated net operating income ("NOI") and excludes our share of investments in unconsolidated entities. Entities in which we have a joint venture with a minority partner are shown at 100% of the joint venture amount. See Non-GAAP Financial Measures for additional information and reconciliation.

The COVID-19 pandemic has had and may continue to have material and adverse effects on our financial condition, results of operations and cash flows in the future. The extent to which the COVID-19 pandemic impacts our operations and those of our operators and tenants will depend on future developments, which are highly uncertain and cannot be predicted with confidence, including the scope, severity and duration of the pandemic, the effectiveness of vaccines, the actions taken to contain the pandemic or mitigate its impact and the direct and indirect economic effects of the pandemic and containment measures, the overall pace of recovery, among others.

Our Seniors Housing Operating revenues are dependent on occupancy. Spot occupancy has steadily increased in recent months, with 94% of communities open for new admissions and nearly all communities allowing visitors, in-person tours and communal dining and activities as of December 31, 2021. Rapid distribution and a high acceptance rate of COVID-19 vaccinations by residents within assisted living and memory care facilities in the U.S. and U.K. have resulted in a significant decrease in total resident case counts across the portfolio from peak levels in mid-January 2021, however, resident case counts have increased in December 2021 as a result of highly transmissible variants.

We have incurred increased operational costs as a result of the introduction of public health measures and other regulations affecting our properties, as well as additional health and safety measures adopted by us and our operators related to the COVID-19 pandemic, including increases in labor, personal protective equipment and sanitation. We expect total Seniors Housing Operating expenses to remain elevated during the pandemic and potentially beyond as these additional health and safety measures become standard practice.

Our Triple-net operators are experiencing similar trends related to occupancy and operating costs as described above with respect to our Seniors Housing Operating properties. However, long-term/post-acute care facilities are generally experiencing a higher degree of occupancy declines. These factors may continue to impact the ability of our Triple-net operators to make contractual rent payments to us in the future. Many of our Triple-net operators received funds under the Coronavirus Aid Relief, and Economic Security Act (“CARES Act”) Paycheck Protection Program and Provider Relief Fund.

During the year ended December 31, 2021, we collected approximately 94% of rent due from operators under Triple-net lease agreements (primarily seniors housing and post-acute care facilities). No significant rent deferrals or rent concessions have been made during the year ended December 31, 2021. We evaluate leases individually and recognize rent on a cash basis if collectibility of substantially all contractual rent payments is not probable. To the extent the prolonged impact of the COVID-19 pandemic causes operators or tenants to seek further modifications of their lease agreements, we may recognize reductions in revenue and increases in uncollectible receivables.

During the early stages of the pandemic in 2020, our Outpatient Medical tenants experienced temporary medical practice closures or decreases in revenue due to government-imposed restrictions on elective medical procedures, stay at home orders or decisions by patients to delay treatments. In some instances, these factors caused tenants to seek modifications of contractual

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

rent obligations. We evaluated each request on a case-by-case basis to determine if a form of rent relief was warranted following an examination of the tenant's financial health, rent coverage, current operating situation and other factors. Virtually all deferred rent related to 2020 deferrals has been paid. During the year ended December 31, 2021, we have continued to collect virtually all rent due from tenants in our Outpatient Medical portfolio, with uncollected amounts primarily attributable to local jurisdictions with COVID-19 related ordinances providing temporary rent relief to tenants.

Business Strategy

Our primary objectives are to protect stockholder capital and enhance stockholder value. We seek to pay consistent cash dividends to stockholders and create opportunities to increase dividend payments to stockholders as a result of annual increases in NOI and portfolio growth. To meet these objectives, we invest across the full spectrum of seniors housing and health care real estate and diversify our investment portfolio by property type, relationship and geographic location.

Substantially all of our revenues are derived from operating lease rentals, resident fees and services and interest earned on outstanding loans receivable. These items represent our primary sources of liquidity to fund distributions and depend upon the continued ability of our obligors to make contractual rent and interest payments to us and the profitability of our operating properties. To the extent that our obligors/partners experience operating difficulties and become unable to generate sufficient cash to make payments or operating distributions to us, there could be a material adverse impact on our consolidated results of operations, liquidity and/or financial condition. To mitigate this risk, we monitor our investments through a variety of methods determined by the type of property. Our asset management process for seniors housing properties generally includes review of monthly financial statements and other operating data for each property, review of obligor/partner creditworthiness, property inspections and review of covenant compliance relating to licensure, real estate taxes, letters of credit and other collateral. Our internal property management division manages and monitors the outpatient medical portfolio with a comprehensive process including review of tenant relations, lease expirations, the mix of health service providers, hospital/health system relationships, property performance, capital improvement needs and market conditions among other things. We evaluate the operating environment in each property’s market to determine the likely trend in operating performance of the facility. When we identify unacceptable trends, we seek to mitigate, eliminate or transfer the risk. Through these efforts, we generally aim to intervene at an early stage to address any negative trends, and in so doing, support both the collectability of revenue and the value of our investment.

In addition to our asset management and research efforts, we also aim to structure our relevant investments to mitigate payment risk. Operating leases and loans are normally credit enhanced by guarantees and/or letters of credit. In addition, operating leases are typically structured as master leases and loans are generally cross-defaulted and cross-collateralized with other real estate loans, operating leases or agreements between us and the obligor and its affiliates.

For the year ended December 31, 2021, resident fees and services and rental income represented 67% and 29%, respectively, of total revenues. Substantially all of our operating leases are designed with escalating rent structures. Leases with fixed annual rental escalators are generally recognized on a straight-line basis over the initial lease period, subject to a collectability assessment. Rental income related to leases with contingent rental escalators is generally recorded based on the contractual cash rental payments due for the period. Our yield on loans receivable depends upon a number of factors, including the stated interest rate, the average principal amount outstanding during the term of the loan and any interest rate adjustments.

Our primary sources of cash include resident fees and services, rent and interest receipts, borrowings under our unsecured revolving credit facility and commercial paper program, public issuances of debt and equity securities, proceeds from investment dispositions and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including acquisitions, capital expenditures, construction advances and transaction costs), loan advances, property operating expenses, general and administrative expenses and other expenses. Depending upon the availability and cost of external capital, we believe our liquidity is sufficient to fund these uses of cash.

We also continuously evaluate opportunities to finance future investments. New investments are generally funded from temporary borrowings under our unsecured revolving credit facility and commercial paper program, internally generated cash and the proceeds from investment dispositions. Our investments generate cash from NOI and principal payments on loans receivable. Permanent financing for future investments, which replaces funds drawn under our unsecured revolving credit facility and commercial paper program, has historically been provided through a combination of the issuance of public debt and equity securities and the incurrence or assumption of secured debt.

Depending upon market conditions, we believe that new investments will be available in the future with spreads over our cost of capital that will generate appropriate returns to our stockholders. It is also likely that investment dispositions may occur in the future. To the extent that investment dispositions exceed new investments, our revenues and cash flows from operations could be adversely affected. We expect to reinvest the proceeds from any investment dispositions in new investments. To the extent that new investment requirements exceed our available cash on-hand, we expect to borrow under our unsecured revolving credit facility and commercial paper program. At December 31, 2021, we had $269,265,000 of cash and cash equivalents, $77,490,000 of restricted cash and $3,675,000,000 of available borrowing capacity under our unsecured revolving credit facility.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Key Transactions

Capital  The following summarizes key capital transactions that occurred during the year ended December 31, 2021:

•In March 2021, we completed the issuance of $750,000,000 senior unsecured notes bearing interest at 2.80% with a maturity date of June 2031.

•In April 2021, we repaid our $339,128,000 of our 3.75% senior unsecured notes due March 2023, $334,624,000 of our 3.95% senior unsecured notes due September 2023, and $15,000,000 of our term loan due April 2022.

•In June 2021, we closed on a new $4,700,000,000 unsecured credit facility with improved pricing across our line of credit and terminated the existing unsecured credit facility. The credit facility includes $4,000,000,000 of revolving credit capacity at a borrowing rate of 77.5 basis points ("bps") over LIBOR, $500,000,000 of USD term loan capacity at a borrowing rate of 90.0 bps over LIBOR and $250,000,000 CAD term loan capacity at 90.0 bps over CDOR.

•In June 2021, we repaid the remaining $845,000,000 of our term loan due April 2022.

•In June 2021, we completed the issuance of $500,000,000 senior unsecured notes bearing interest at 2.05% with a maturity date of January 2029.

•In July 2021, we entered into an amended and restated ATM Program (as defined below) pursuant to which we may offer and sell up to $2,500,000,000 of common stock from time to time. During 2021, we sold 34,854,598 shares of common stock under our current and previous ATM Programs via forward sale agreements which are expected to generate gross proceeds of approximately $2,820,855,000, of which 29,667,348 shares have been settled resulting in $2,385,683,000 of gross proceeds during the year ended December 31, 2021.

•In November 2021, we completed the issuance of $500,000,000 senior unsecured notes bearing interest at 2.75% with a maturity date of January 2032.

•We extinguished $132,031,000 of secured debt at a blended average interest rate of 5.86% throughout 2021.

Investments The following summarizes property acquisitions and joint venture investments completed during the year ended December 31, 2021 (dollars in thousands):

PropertiesBook Amount(1)Capitalization Rates(2)
Seniors Housing Operating151$3,138,9885.1%
Triple-net35898,1676.1%
Outpatient Medical19403,4585.5%
Totals205$4,440,6135.2%

(1) Represents amounts recorded in net real estate investments including fair value adjustments pursuant to U.S. GAAP. See Note 3 to our consolidated financial statements for additional information.

(2) Represents annualized contractual or projected NOI to be received in cash divided by investment amounts.

Dispositions The following summarizes property dispositions completed during the year ended December 31, 2021 (dollars in thousands):

PropertiesProceeds(1)Book Amount(2)Capitalization Rates(3)
Seniors Housing Operating12$118,590$112,8374.8%
Triple-net51625,478486,3697.2%
Outpatient Medical11326,254229,6605.3%
Totals74$1,070,322$828,8666.4%

(1) Represents pro rata proceeds received upon disposition including any seller financing.

(2) Represents carrying value of net real estate assets at time of disposition. See Note 5 to our consolidated financial statements for additional information.

(3) Represents annualized contractual income that was being received in cash at date of disposition divided by disposition proceeds.

Dividends Our Board of Directors declared a cash dividend for the quarter ended December 31, 2021 of $0.61 per share. On March 8, 2022, we will pay our 203rd consecutive quarterly dividend payment to stockholders of record on March 1, 2022.

Key Performance Indicators, Trends and Uncertainties

We utilize several key performance indicators to evaluate the various aspects of our business. These indicators are discussed below and relate to operating performance, credit strength and concentration risk. Management uses these key performance indicators to facilitate internal and external comparisons to our historical operating results, in making operating decisions, and for budget planning purposes.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Operating Performance We believe that net income and net income attributable to common stockholders (“NICS”) per the Consolidated Statements of Comprehensive Income are the most appropriate earnings measures. Other useful supplemental measures of our operating performance include funds from operations attributable to common stockholders (“FFO”) and consolidated net operating income (“NOI”); however, these supplemental measures are not defined by U.S. GAAP. Please refer to the section entitled “Non-GAAP Financial Measures” for further discussion and reconciliations. These earnings measures are widely used by investors and analysts in the valuation, comparison and investment recommendations of companies. The following table reflects the recent historical trends of our operating performance measures for the periods presented (in thousands):

Year Ended December 31,
202120202019
Net income$374,479$1,038,852$1,330,410
Net income attributable to common stockholders336,138978,8441,232,432
Funds from operations attributable to common stockholders1,220,7221,102,5621,577,080
Consolidated net operating income1,967,5532,008,1442,431,264

Credit Strength We measure our credit strength both in terms of leverage ratios and coverage ratios. The leverage ratios indicate how much of our balance sheet capitalization is related to long-term debt, net of cash and restricted cash. The coverage ratios indicate our ability to service interest and fixed charges (interest and secured debt principal amortization). We expect to maintain capitalization ratios and coverage ratios sufficient to maintain a capital structure consistent with our current profile. The coverage ratios are based on adjusted earnings before interest, taxes, depreciation and amortization (“Adjusted EBITDA”). Please refer to the section entitled “Non-GAAP Financial Measures” for further discussion and reconciliation of these measures. Leverage ratios and coverage ratios are widely used by investors, analysts and rating agencies in the valuation, comparison, investment recommendations and rating of companies. The following table reflects the recent historical trends for our credit strength measures for the periods presented:

Year Ended December 31,
202120202019
Net debt to book capitalization ratio42.2%40.8%46.3%
Net debt to undepreciated book capitalization ratio34.9%33.8%39.2%
Net debt to market capitalization ratio25.9%29.6%29.5%
Adjusted interest coverage ratio3.89x3.97x4.14x
Adjusted fixed charge coverage ratio3.43x3.54x3.78x

Concentration Risk We evaluate our concentration risk in terms of NOI by property mix, relationship mix and geographic mix. Concentration risk is a valuable measure in understanding what portion of our NOI could be at risk if certain sectors were to experience downturns. Property mix measures the portion of our NOI that relates to our various property types. Relationship mix measures the portion of our NOI that relates to our current top five relationships. Geographic mix measures the portion of our NOI that relates to our current top five states (or international equivalents). The following table reflects our recent historical trends of concentration risk by NOI for the years indicated below:

December 31,(1)
202120202019
Property mix:
Seniors Housing Operating35%38%43%
Triple-net43%37%38%
Outpatient Medical22%25%19%
Relationship mix:
ProMedica12%11%9%
Sunrise Senior Living(2)10%13%14%
Revera(2)5%5%6%
Avery Healthcare4%4%3%
HC-One Group3%—%—%
Remaining66%67%68%
Geographic mix:
California13%14%13%
United Kingdom13%10%8%
Texas8%9%8%
Canada6%6%7%
New Jersey6%5%7%
Remaining54%56%57%

(1) Excludes our share of investments in unconsolidated entities and non-segment/corporate NOI. Entities in which we have a joint venture with a minority partner are shown at 100% of the joint venture amount.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

(2) Revera owns a controlling interest in Sunrise Senior Living.

We evaluate our key performance indicators in conjunction with current expectations to determine if historical trends are indicative of future results. Our expected results may not be achieved and actual results may differ materially from our expectations. Factors that may cause actual results to differ from expected results are described in more detail in “Item 1 — Business — Cautionary Statement Regarding Forward-Looking Statements” and “Item 1A — Risk Factors” and other sections of this Annual Report on Form 10-K. Management regularly monitors economic and other factors to develop strategic and tactical plans designed to improve performance and maximize our competitive position. Our ability to achieve our financial objectives is dependent upon our ability to effectively execute these plans and to appropriately respond to emerging economic and company-specific trends. Please refer to “Item 1 — Business,” “Item 1A — Risk Factors” in this Annual Report on Form 10-K for further discussion of these risk factors.

Corporate Governance

Maintaining investor confidence and trust is important in today’s business environment. Our Board of Directors and management are strongly committed to policies and procedures that reflect the highest level of ethical business practices. Our corporate governance guidelines provide the framework for our business operations and emphasize our commitment to increase stockholder value while meeting all applicable legal requirements. These guidelines meet the listing standards adopted by the New York Stock Exchange and are available on the Internet at www.welltower.com/investors/governance. The information on our website is not incorporated by reference in this Annual Report on Form 10-K, and our web address is included as an inactive textual reference only.

Liquidity and Capital Resources

Sources and Uses of Cash

Our primary sources of cash include resident fees and services, rent and interest receipts, borrowings under our unsecured revolving credit facility and commercial paper program, public issuances of debt and equity securities, proceeds from investment dispositions and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including acquisitions, capital expenditures, construction advances and transaction costs), loan advances, property operating expenses, general and administrative expenses and other expenses. These sources and uses of cash are reflected in our Consolidated Statements of Cash Flows and are discussed in further detail below. The following is a summary of our sources and uses of cash flows for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20212020$%2019$%$%
Cash, cash equivalents and restricted cash at beginning of period$2,021,043$385,766$1,635,277424%$316,129$69,63722%$1,704,914539%
Net cash provided from (used in):
Operating activities1,275,3251,364,756(89,431)-7%1,535,968(171,212)-11%(260,643)-17%
Investing activities(4,516,268)2,347,928(6,864,196)n/a(2,048,791)4,396,719n/a(2,467,477)120%
Financing activities1,567,664(2,080,858)3,648,522n/a577,150(2,658,008)n/a990,514172%
Effect of foreign currency translation(1,009)3,451(4,460)n/a5,310(1,859)-35%(6,319)n/a
Cash, cash equivalents and restricted cash at end of period$346,755$2,021,043$(1,674,288)-83%$385,766$1,635,277424%$(39,011)-10%

Operating Activities The changes in net cash provided from operating activities are primarily attributable to declines in revenue as a result of decreased occupancy at our Seniors Housing Operating properties, straight-line receivable reserves related to Triple-net leases during the year ended December 31, 2021 and dispositions. Please see “Results of Operations” for discussion of net income fluctuations. For the years ended December 31, 2021, 2020 and 2019, cash flows from operations exceeded cash distributions to stockholders.

Investing Activities  The changes in net cash provided from/used in investing activities are primarily attributable to net changes in real property investments and dispositions, loans receivable and investments in unconsolidated entities which are summarized above in “Key Transactions.” Please refer to Notes 3 and 5 of our consolidated financial statements for additional information. The following is a summary of cash used in non-acquisition capital improvement activities for the periods presented (dollars in thousands):

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20212020$%2019$%$%
New development$417,963$201,336$216,627108%$323,488$(122,152)-38%$94,47529%
Recurring capital expenditures, tenant improvements and lease commissions99,99483,14616,84820%136,535(53,389)-39%(36,541)-27%
Renovations, redevelopments and other capital improvements182,594161,84320,75113%192,289(30,446)-16%(9,695)-5%
Total$700,551$446,325$254,22657%$652,312$(205,987)-32%$48,2397%

The change in new development is primarily due to the number and size of construction projects on-going during the relevant periods. Renovations, redevelopments and other capital improvements include expenditures to maximize property value, increase net operating income, maintain a market-competitive position and/or achieve property stabilization.

Financing Activities The changes in net cash provided from/used in financing activities are primarily attributable to changes related to our long-term debt arrangements, the issuances of common stock and dividend payments which are summarized above in “Key Transactions.” Please refer to Notes 10, 11 and 14 of our consolidated financial statements for additional information.

In March 2021, we completed the issuance of $750,000,000 senior unsecured notes with a maturity date of June 2031. In June 2021, we completed the issuance of $500,000,000 senior unsecured notes with a maturity date of January 2029. Net proceeds from these debt issuances were used to redeem the remaining $339,128,000 of our 3.75% senior unsecured notes due 2023, $334,624,000 of our 3.95% senior unsecured notes due 2023, and $860,000,000 remaining on our term loan due April 2022. In June 2021, we closed on a new $4,700,000,000 unsecured credit facility. The credit facility includes $4,000,000,000 of revolving credit capacity. In November 2021, we completed the issuance of $500,000,000 senior unsecured notes with a maturity date of January 2032. As of December 31, 2021, we have total near-term available liquidity of approximately $4.0 billion.

Off-Balance Sheet Arrangements

At December 31, 2021, we had investments in unconsolidated entities with our ownership generally ranging from 10% to 65%. We use financial derivative instruments to hedge interest rate and foreign currency exchange rate exposure. At December 31, 2021, we had 15 outstanding letter of credit obligations. Please see Notes 8, 12 and 13 to our consolidated financial statements for additional information.

Contractual Obligations

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following table summarizes our payment requirements under contractual obligations as of December 31, 2021 (in thousands):

Payments Due by Period
Contractual ObligationsTotal20222023-20242025-2026Thereafter
Unsecured credit facility and commercial paper(1)$325,000$325,000$$$
Senior unsecured notes and term credit facilities:(1)
U.S. Dollar senior unsecured notes9,350,0001,350,0001,950,0006,050,000
Canadian Dollar senior unsecured notes(2)234,797234,797
Pounds Sterling senior unsecured notes(2)1,417,5001,417,500
U.S. Dollar term credit facility510,000500,00010,000
Canadian Dollar term credit facility(2)195,664195,664
Secured debt:(1,2)
Consolidated2,202,312582,884733,426267,754618,248
Unconsolidated1,247,746149,218291,969546,525260,034
Contractual interest obligations:(3)
Unsecured credit facility and commercial paper6565
Senior unsecured notes and term loans(2)3,815,957427,904826,167648,5801,913,306
Consolidated secured debt(2)245,38361,44478,21848,13557,586
Unconsolidated secured debt(2)188,24440,24468,70926,93152,360
Finance lease liabilities(4)210,8578,69871,6343,354127,171
Operating lease liabilities(4)1,383,35045,15191,85087,3011,159,048
Purchase obligations(5)1,378,920826,122534,8495,53312,416
Total contractual obligations$22,705,795$2,466,730$4,742,486$3,594,113$11,902,466

(1) Amounts represent principal amounts due and do not reflect unamortized premiums/discounts or other fair value adjustments as reflected on the Consolidated Balance Sheets.

(2) Based on foreign currency exchange rates in effect as of balance sheet date.

(3) Based on variable interest rates in effect as of December 31, 2021.

(4) See Note 6 to our consolidated financial statements for additional information.

(5) See Note 13 to our consolidated financial statements for additional information.

Capital Structure

Please refer to “Credit Strength” above for a discussion of our leverage and coverage ratio trends. Our debt agreements contain various covenants, restrictions and events of default. Certain agreements require us to maintain financial ratios and minimum net worth and impose certain limits on our ability to incur indebtedness, create liens and make investments or acquisitions. As of December 31, 2021, we were in compliance in all material respects with the covenants under our debt agreements. None of our debt agreements contain provisions for acceleration which could be triggered by our debt ratings. However, under our primary unsecured credit facility, the ratings on our senior unsecured notes are used to determine the fees and interest charged. We plan to manage the company to maintain compliance with our debt covenants and with a capital structure consistent with our current profile. Any downgrades in terms of ratings or outlook by any or all of the rating agencies could have a material adverse impact on our cost and availability of capital, which could have a material adverse impact on our consolidated results of operations, liquidity and/or financial condition.

On May 4, 2021, we filed with the Securities and Exchange Commission (the “SEC”) (1) an open-ended automatic or “universal” shelf registration statement on Form S-3 covering an indeterminate amount of future offerings of debt securities, common stock, preferred stock, depositary shares, warrants and units to replace our existing “universal” shelf registration statement filed with the SEC on May 17, 2018, and (2) a registration statement in connection with our enhanced dividend reinvestment plan (“DRIP”) under which we may issue up to 15,000,000 shares of common stock to replace our existing DRIP registration statement on Form S-3 filed with the SEC on May 17, 2018. As of February 4, 2022, 15,000,000 shares of common stock remained available for issuance under the DRIP registration statement. On July 30, 2021, we entered into (i) an amended and restated equity distribution agreement (the “EDA”) with each of Robert W. Baird & Co. Incorporated, Barclays Capital Inc., BMO Capital Markets Corp., BNP Paribas Securities Corp., BNY Mellon Capital Markets, LLC, BofA Securities, Inc., BOK Financial Securities, Inc., Capital One Securities Inc., Citigroup Global Markets Inc., Comerica Securities, Inc., Credit Agricole Securities (USA) Inc., Deutsche Bank Securities Inc., Fifth Third Securities, Inc., Goldman Sachs & Co. LLC, Hancock Whitney Investment Services, Inc., Jefferies LLC, J.P. Morgan Securities LLC, KeyBanc Capital Markets Inc., Loop

52

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Capital Markets LLC, Mizuho Securities USA LLC, Morgan Stanley & Co. LLC, MUFG Securities Americas Inc., RBC Capital Markets, LLC, Regions Securities LLC, Scotia Capital (USA) Inc., SMBC Nikko Securities America, Inc., Stifel, Nicolaus & Company, Incorporated, Synovus Securities, Inc., TD Securities (USA) LLC, Truist Securities, Inc. and Wells Fargo Securities, LLC relating to the offer and sale from time to time of up to $2,500,000,000 aggregate amount of our common stock and (ii) separate master forward sale confirmations with each of Bank of America, N.A., Bank of Montreal, The Bank of New York Mellon, Barclays Bank PLC, BNP Paribas, Citibank, N.A., Crédit Agricole Corporate and Investment Bank, Deutsche Bank AG, London Branch, Goldman Sachs & Co. LLC, Jefferies LLC, JPMorgan Chase Bank, National Association, KeyBanc Capital Markets Inc., Mizuho Markets Americas LLC, Morgan Stanley & Co. LLC, MUFG Securities EMEA plc, Royal Bank of Canada, The Bank of Nova Scotia, The Toronto-Dominion Bank, Truist Bank, London Branch and Wells Fargo Bank, National Association (together with the EDA, the “ATM Program”), amending and restating the ATM Program entered into on May 4, 2021 to, among other amendments, increase the total amount of shares of common stock that may be offered and sold under the ATM Program from $2,000,000,000 to $2,500,000,000, which amount excludes shares the Company has previously sold pursuant to the prior program. The ATM Program also allows us to enter into forward sale agreements. As of February 4, 2022, we had $1,876,085,000 of remaining capacity under the ATM Program, which excludes forward sales agreements outstanding for the sale of 10,924,956 shares or approximately $930,610,000 with maturity dates in 2022. We expect to physically settle the forward sales for cash proceeds. Depending upon market conditions, we anticipate issuing securities under our registration statements to invest in additional properties and to repay borrowings under our unsecured revolving credit facility and commercial paper program.

In connection with the filing of the new “universal” shelf registration statement, the Company also filed with the SEC two prospectus supplements that will continue offerings that were previously covered by prospectus supplements and the accompanying prospectus to the prior registration statement relating to: (i) the registration and possible issuance of up to 620,731 shares of the Company’s common stock (the “DownREIT Shares”), that may be issued from time to time if, and to the extent that, certain holders of Class A units (the “DownREIT Units”) of HCN G&L DownREIT, LLC, a Delaware limited liability company (the “DownREIT”), tender such DownREIT Units for redemption by the DownREIT, and HCN DownREIT Member, LLC, a majority-owned indirect subsidiary of the Company (including its permitted successors and assigns, the “Managing Member”), or a designated affiliate of the Managing Member, elects to assume the redemption obligations of the DownREIT and to satisfy all or a portion of the redemption consideration by issuing DownREIT Shares to the holders instead of or in addition to paying a cash amount; and (ii) the registration and possible issuance of up to 475,327 shares common stock (the “DownREIT II Shares”), that may be issued from time to time if, and to the extent that, certain holders of Class A units (the “DownREIT II Units,” and collectively with the DownREIT Units, the “Units”) of HCN G&L DownREIT II LLC, a Delaware limited liability company (the “DownREIT II”), tender such DownREIT II Units for redemption by the DownREIT II, and the Managing Member, or a designated affiliate of the Managing Member, elects to assume the redemption obligations of the DownREIT II and to satisfy all or a portion of the redemption consideration by issuing DownREIT II Shares to the holders instead of or in addition to paying a cash amount.

Results of Operations

Summary

Our primary sources of revenue include resident fees and services, rent and interest income. Our primary expenses include property operating expenses, depreciation and amortization, interest expense, general and administrative expenses, and other expenses. We evaluate our business and make resource allocations on our three business segments: Seniors Housing Operating, Triple-net and Outpatient Medical. The primary performance measures for our properties are NOI and same store NOI (SSNOI) and other supplemental measures include FFO and Adjusted EBITDA, which are further discussed below. Please see Non-GAAP Financial Measures for additional information and reconciliations related to these supplemental measures.

This section of this Form 10-K generally discusses 2021 and 2020 items and year-to-year comparisons between 2021 and 2020. Discussions of 2019 items and year-to-year comparisons between 2020 and 2019 that are not included in this Form 10-K can be found in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 of the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2020.

The following is a summary of our results of operations for the periods presented (dollars in thousands, except per share amounts):

53

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20212020Amount%2019Amount%Amount%
Net income$374,479$1,038,852$(664,373)-64%$1,330,410$(291,558)-22%$(955,931)-72%
NICS336,138978,844(642,706)-66%1,232,432(253,588)-21%(896,294)-73%
FFO1,220,7221,102,562118,16011%1,577,080(474,518)-30%(356,358)-23%
Adjusted EBITDA1,913,5462,048,412(134,866)-7%2,328,202(279,790)-12%(414,656)-18%
Consolidated NOI1,967,5532,008,144(40,591)-2%2,431,264(423,120)-17%(463,711)-19%
Per share data (fully diluted):
Net income attributable to common stockholders (1)$0.78$2.33$(1.55)-67%$3.05$(0.72)-24%$(2.27)-74%
Funds from operations attributable to common stockholders$2.86$2.64$0.228%$3.91$(1.27)-32%$(1.05)-27%
Adjusted interest coverage ratio3.89x3.97x-0.08x-2%4.14x-0.17x-4%-0.25x-6%
Adjusted fixed charge coverage ratio3.43x3.54x-0.11x-3%3.78x-0.24x-6%-0.35x-9%
(1) Includes adjustment to the numerator for income (loss) attributable to OP unitholders.

The following table represents the changes in outstanding common stock for the period from January 1, 2019 to December 31, 2021 (in thousands):

Year Ended
December 31, 2021December 31, 2020December 31, 2019Totals
Beginning balance$417,401$410,257$383,675$383,675
Dividend reinvestment plan issuances2645,7996,063
Preferred stock conversions12,71212,712
Option exercises3381111
ATM Program issuances29,6676,8007,85644,323
Repurchase of common stock(202)(202)
Other, net171282204657
Ending balance$447,239$417,401$410,257$447,239
Weighted average number of shares outstanding:
Basic424,976415,451401,845
Diluted426,841417,387403,808

During the past three years, inflation has not significantly affected our earnings because of the moderate inflation rate. Additionally, a portion of our earnings are derived primarily from long-term investments with predictable rates of return. These investments are mainly financed with a combination of equity, senior unsecured notes, secured debt and borrowings under our primary unsecured credit facility. During inflationary periods, which generally are accompanied by rising interest rates, our ability to grow may be adversely affected because the yield on new investments may increase at a slower rate than new borrowing costs.

Seniors Housing Operating

The following is a summary of our SSNOI at Welltower's Share for the Seniors Housing Operating segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2021December 31, 2020$%December 31, 2021December 31, 2020$%
SSNOI(1)$136,344$144,197$(7,853)-5.4%$543,755$652,823$(109,068)-16.7%

(1) Relates to 489 properties for the QTD Pool and 477 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

The following is a summary of our results of operations for the Seniors Housing Operating segment for the years presented (dollars in thousands):

54

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20212020$%2019$%$%
Revenues:
Resident fees and services$3,197,223$3,074,022$123,2014%$3,448,175$(374,153)-11%$(250,952)-7%
Interest income4,2316183,613585%36582n/a4,195n/a
Other income11,7967,2234,57363%8,658(1,435)-17%3,13836%
Total revenues3,213,2503,081,863131,3874%3,456,869(375,006)-11%(243,619)-7%
Property operating expenses2,529,3442,326,311203,0339%2,417,349(91,038)-4%111,9955%
NOI(1)683,906755,552(71,646)-9%1,039,520(283,968)-27%(355,614)-34%
Other expenses:n/a
Depreciation and amortization593,565544,46249,1039%553,189(8,727)-2%40,3767%
Interest expense39,32754,901(15,574)-28%67,983(13,082)-19%(28,656)-42%
Loss (gain) on extinguishment of debt, net(2,628)12,659(15,287)-121%1,61411,045684%(4,242)-263%
Provision for loan losses, net394671(277)-41%671n/a394n/a
Impairment of assets22,317100,741(78,424)-78%2,14598,596n/a20,172940%
Other expenses27,13214,26512,86790%26,348(12,083)-46%7843%
680,107727,699(47,592)-7%651,27976,42012%28,8284%
Income (loss) from continuing operations before income taxes and other items3,79927,853(24,054)-86%388,241(360,388)-93%(384,442)-99%
Income (loss) from unconsolidated entities(39,225)(33,857)(5,368)-16%12,388(46,245)-373%(51,613)-417%
Gain (loss) on real estate dispositions, net6,146328,249(322,103)-98%528,747(200,498)-38%(522,601)-99%
Income from continuing operations(29,280)322,245(351,525)-109%929,376(607,131)-65%(958,656)-103%
Net income (loss)(29,280)322,245(351,525)-109%929,376(607,131)-65%(958,656)-103%
Less: Net income (loss) attributable to noncontrolling interests(2,224)20,301(22,525)-111%56,513(36,212)-64%(58,737)-104%
Net income (loss) attributable to common stockholders$(27,056)$301,944$(329,000)-109%$872,863$(570,919)-65%$(899,919)-103%

(1) See Non-GAAP Financial Measures below.

Resident fees and services and property operating expenses for the year ended December 31, 2021 increased compared to the prior year primarily due to acquisitions, including the acquisition of the Holiday Retirement portfolio on July 30, 2021 for a total purchase price of $1.6 billion. The increases were partially offset by decreases in spot occupancy across the portfolio due to the COVID-19 pandemic and property dispositions. Spot occupancy remains below pre-pandemic levels but has steadily increased in recent months, with 94% of communities open for new admissions and nearly all communities allowing visitors, in-person tours and communal dining and activities as of December 31, 2021. Rapid distribution and a high acceptance rate of COVID-19 vaccinations by residents within assisted living and memory care facilities in the U.S. and U.K. have resulted in a significant decrease in total resident case counts across the portfolio from peak levels in mid-January 2021, however, resident case counts have increased in December 2021 as a result of highly transmissible variants. As of December 31, 2021, occupancy has increased approximately 510 bps to 77.7% since the pandemic-low of 72.6% on March 12, 2021. Quarterly spot occupancy rates through December 31, 2021 are as follows:

December 31, 2020March 31, 2021June 30, 2021September 30, 2021December 31, 2021
Spot occupancy (1)74.9%72.9%74.8%76.9%77.7%
Sequential occupancy change(2)(1.9)%1.9%2.1%0.7%

(1) Spot occupancy represents approximate month end occupancy at our share for 546 properties in operation as of December 31, 2020, including unconsolidated properties but excluding acquisitions, executed dispositions, development conversions and one property closed for redevelopment.

(2) Sequential occupancy changes are based on actual spot occupancy and may not recalculate due to rounding.

During the year ended December 31, 2021, the U.S. and U.K. portfolios reported spot occupancy gains of approximately 490 bps and 80 bps, respectively. Canada reported a spot occupancy decline of approximately 290 bps.

On March 27, 2020, the federal government enacted CARES Act to provide financial aid to individuals, businesses, and state and local governments. During the years ended December 31, 2021 and 2020, we received government grants under the CARES Act primarily to cover increased expenses and lost revenue during the COVID-19 pandemic, as well as under similar programs in the U.K. and Canada. Grant income is recognized when there is reasonable assurance that the grant will be received and the Company will comply with all conditions attached to the grant. Additionally, grants are recognized over the periods in which the Company recognizes the increased expenses and lost revenue the grants are intended to defray. For the years ended December 31, 2021 and 2020 we recognized $97,933,000 and $31,927,000, respectively, of government grant income as a reduction to property operating expenses in our Consolidated Statements of Comprehensive Income. Additionally, for the years ended December 31, 2021 and 2020, we recognized $4,642,000 and $3,014,000, respectively, of government grant income in other income. The amount of qualifying expenditures and lost revenue exceeded grant income recognized and the Company believes it has complied and will continue to comply with all grant conditions.

55

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Property-level operating expenses associated with the COVID-19 pandemic relating to our Seniors Housing Operating portfolio totaled $63,681,000 and $110,719,000 for the years ended December 31, 2021 and 2020, respectively. These expenses were incurred as a result of the introduction of public health measures and other regulations affecting our properties, as well as additional health and safety measures adopted by us and our operators related to the COVID-19 pandemic, including increases in labor and property cleaning expenses and expenditures related to our efforts to procure personal protective equipment ("PPE") and supplies, net of reimbursements. Specifically in 2021, we incurred elevated labor expenses resulting from the increased utilization of contract labor due to the rise in occupancy and a challenging labor market.

During the year ended December 31, 2021, we recorded impairment charges of $22,317,000 related to two held for use properties in which the carrying value exceeded the estimated fair value. During the year ended December 31, 2020, we recorded impairment charges of $100,741,000 related to 15 held for sale or sold properties and six held for use properties. Transaction costs related to asset acquisitions are capitalized as a component of the purchase price. The fluctuation in other expenses is primarily due to the timing of noncapitalizable transaction costs associated with acquisitions and operator transitions. Changes in the gain on sales of properties are related to the volume and timing of property sales and the sales prices. During the year ended December 31, 2020, we recognized a gain on real estate disposition of $312,249,000 related to an 11 property U.S. portfolio.

Depreciation and amortization fluctuates as a result of acquisitions, disposition and transitions. To the extent we acquire or dispose of additional properties in the future, our provision for depreciation and amortization will change accordingly.

During the year ended December 31, 2021, we completed two Seniors Housing Operating construction projects representing $117,386,000 or $553,573 per unit. The following is a summary of our consolidated Seniors Housing Operating construction projects, excluding expansions, pending as of December 31, 2021 (dollars in thousands):

LocationUnits/BedsCommitmentBalanceEst. Completion
Hendon, UK102$74,925$68,8231Q22
Barnet, UK10069,93060,7221Q22
Georgetown, TX18836,21514,0822Q22
New Rochelle, NY7242,66913,1863Q22
Sachse, TX19338,05412,6933Q22
Princeton, NJ8029,78025,1673Q22
Pflugerville, TX19639,50010,5434Q22
Denton, TX6520,1945,2454Q22
Berea, OH12014,93410,7144Q22
Painesville, OH11914,4628,9124Q22
Beaver, PA11614,1847,7064Q22
Lake Jackson, TX13032,0203,7262Q23
White Marsh, MD18878,6107,6203Q23
Weymouth, MA16577,54510,1883Q23
Miami Twp, OH12218,2062,0714Q23
Charlotte, NC32896,41631,5201Q24
Gaithersburg, MD302173,54825,9862Q24
Temple, TX24565,5695,2904Q24
Kyle, TX22562,7004,4571Q25
3,056$999,461328,651
Boise, ID(1)33,216
Brookhaven, GA(1)10,439
Brookline, MA(1)30,732
Columbus, OH(1)13,170
Raleigh, NC(1)3,508
Toronto, ON(1)49,901
Washington, DC(1)31,276
Wellesley, MA(1)9,132
$510,025
(1) Final units/beds, commitment amount and expected conversion date not yet known.

Interest expense represents secured debt interest expense, which fluctuates based on the net effect and timing of assumptions, segment transitions, fluctuations in foreign currency rates, extinguishments and principal amortizations. The fluctuations in loss (gain) on extinguishment of debt is primarily attributable to the volume of extinguishments and terms of the related secured debt. The following is a summary of our Seniors Housing Operating segment property secured debt principal activity (dollars in thousands):

56

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Year EndedYear EndedYear Ended
December 31, 2021December 31, 2020December 31, 2019
Weighted Avg.Weighted Avg.Weighted Avg.
AmountInterest RateAmountInterest RateAmountInterest Rate
Beginning balance$1,706,1893.05%$2,115,0373.54%$1,810,5873.87%
Debt issued23,5692.83%62,0552.55%343,6963.11%
Debt assumed—%—%183,0614.58%
Debt extinguished(77,959)6.14%(441,208)2.18%(219,864)4.28%
Debt transferred out—%—%(12,072)3.89%
Principal payments(50,603)3.03%(48,498)3.30%(43,997)3.45%
Foreign currency(1,674)2.67%18,8032.93%53,6263.33%
Ending balance$1,599,5222.81%$1,706,1893.05%$2,115,0373.54%
Monthly averages$1,649,4852.88%$1,875,9103.19%$1,966,8923.70%

The majority of our Seniors Housing Operating properties are formed through partnership interests. Net income attributable to noncontrolling interests represents our partners’ share of net income (loss) related to joint ventures. The decrease compared to the year ended December 31, 2020 relates primarily to our partners' share of gains on real estate dispositions during that year.

Triple-net

The following is a summary of our SSNOI at Welltower's Share for the Triple-net segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2021December 31, 2020$%December 31, 2021December 31, 2020$%
SSNOI(1)$148,507$144,131$4,3763.0%$569,484$570,796$(1,312)-0.2%

(1) Relates to 554 properties for the QTD Pool and 547 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

The following is a summary of our results of operations for the Triple-net segment for the years presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20212020$%2019$%$%
Revenues:
Rental income$761,441$733,776$27,6654%$903,798$(170,022)-19%$(142,357)-16%
Interest income124,54062,62561,91599%62,59926%61,94199%
Other income4,6034,903(300)-6%6,246(1,343)-22%(1,643)-26%
Total revenues890,584801,30489,28011%972,643(171,339)-18%(82,059)-8%
Property operating expenses49,46253,183(3,721)-7%53,900(717)-1%(4,438)-8%
NOI(1)841,122748,12193,00112%918,743(170,622)-19%(77,621)-8%
Other expenses:
Depreciation and amortization220,699232,604(11,905)-5%232,626(22)%(11,927)-5%
Interest expense6,3769,477(3,101)-33%12,892(3,415)-26%(6,516)-51%
Loss (gain) on derivatives and financial instruments, net(7,333)11,049(18,382)-166%(4,399)15,448351%(2,934)-67%
Provision for loan losses, net10,33990,563(80,224)-89%18,69071,873385%(8,351)-45%
Impairment of assets26,57934,867(8,288)-24%11,92622,941192%14,653123%
Other expenses4,18922,923(18,734)-82%13,7719,15266%(9,582)-70%
260,849401,483(140,634)-35%285,506115,97741%(24,657)-9%
Income from continuing operations before income taxes and other items580,273346,638233,63567%633,237(286,599)-45%(52,964)-8%
Income (loss) from unconsolidated entities20,68718,4622,22512%22,985(4,523)-20%(2,298)-10%
Gain (loss) on real estate dispositions, net135,88164,28871,593111%218,322(154,034)-71%(82,441)-38%
Income from continuing operations736,841429,388307,45372%874,544(445,156)-51%(137,703)-16%
Net income736,841429,388307,45372%874,544(445,156)-51%(137,703)-16%
Less: Net income attributable to noncontrolling interests35,65339,985(4,332)-11%36,2713,71410%(618)-2%
Net income attributable to common stockholders$701,188$389,403$311,78580%$838,273$(448,870)-54%$(137,085)-16%

(1) See Non-GAAP Financial Measures below.

57

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Rental income has increased primarily due to the timing of the establishment of reserves for straight-line rent receivable balances relating to leases for which collection of substantially all contractual lease payments is no longer deemed probable. During the year ended December 31, 2021, we recorded reserves for previously recognized straight-line rent receivables of $49,241,000. During the year ended December 31, 2020, we recorded $146,508,000, which included $91,025,000 related to Genesis Healthcare ("Genesis") whom noted substantial doubt as to their ability to continue as a going concern.

Certain of our leases contain annual rental escalators that are contingent upon changes in the Consumer Price Index and/or changes in the gross operating revenues of the tenant’s properties. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. If gross operating revenues at our facilities and/or the Consumer Price Index do not increase, a portion of our revenues may not continue to increase. For the three months ended December 31, 2021, we had ten leases with rental rate increasers ranging from 2.00% to 5.94% in our Triple-net portfolio. Our Triple-net operators are experiencing similar impacts on occupancy and operating costs due to the COVID-19 pandemic as described above with respect to our Seniors Housing Operating properties. However, long-term/post-acute facilities have generally experienced a higher degree of occupancy declines, which in some cases impacted the ability of our Triple-net operators to make contractual rent payments to us. However, many of our Triple-net operators received funds under the CARES Act Paycheck Protection Program and Provider Relief Fund. During the year ended December 31, 2021, we collected approximately 94% of rent due from operators under Triple-net lease agreements (primarily seniors housing and post-acute care facilities). No significant deferrals or rent concessions have been made. We evaluate leases individually and recognize rent on a cash basis if collectibility of substantially all contractual rent payments is not probable.

Depreciation and amortization fluctuate as a result of the acquisitions, dispositions and transitions of triple-net properties. To the extent we acquire or dispose of additional properties in the future, our provision for depreciation and amortization will change accordingly.

During the year ended December 31, 2021, we recognized a provision for loan losses under the current expected credit losses accounting standard, primarily related to the initial recognition of the £540 million of senior loan financings to affiliates of Safanad as part of the recapitalization of its investment in HC-One Group during the second quarter. The increase to interest income is primarily driven by interest recognized on this loan funding. Additionally, during the year ended December 31, 2020, we recognized a provision for loan losses of $90,563,000, of which $80,873,000 represents additional reserves as a result of the current collateral estimate related to the Genesis outstanding loans.

During the year ended December 31, 2021, we recorded impairment charges of $26,579,000 related to four held for sale or sold properties and two held for use properties. During the year ended December 31, 2020, we recorded impairment charges of $34,867,000 related to one held for sale and four held for use properties. Transaction costs related to asset acquisitions are capitalized as a component of purchase price. The fluctuation in other expenses is primarily due to noncapitalizable transaction costs from acquisitions and segment transitions. Changes in the gain on sales of properties are related to the volume and timing of property sales and the sales prices.

During the year ended December 31, 2021, we completed one Triple-net construction project representing $22,990,000 or $280,366 per unit. The following is a summary of our consolidated Triple-net construction projects, excluding expansions, pending as of December 31, 2021 (dollars in thousands):

LocationUnits/BedsCommitmentBalanceEst. Completion
Redhill, UK76$21,465$18,3471Q22
London, UK8243,55922,9812Q22
Wombourne, UK6616,20010,4224Q22
Leicester, UK6015,1209,0474Q22
Rugby, UK7620,6738,4874Q22
Raleigh, NC191154,2564805000048,0502Q23
Total551$271,273$117,334

During the year ended December 31, 2021, loss (gain) on derivatives and financial instruments, net is primarily attributable to the mark-to-market of the equity warrants received as part of the Safanad/HC-One transaction that closed in the second quarter. In addition, the mark-to-market adjustment on our Genesis available-for-sale investment is reflected in all periods.

Interest expense represents secured debt interest expense and related fees. The change in secured debt interest expense is due to the net effect and timing of assumptions, segment transitions, fluctuations in foreign currency rates, extinguishments and principal amortizations. The following is a summary of our Triple-net secured debt principal activity for the periods presented (dollars in thousands):

58

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Year EndedYear EndedYear Ended
December 31, 2021December 31, 2020December 31, 2019
Weighted Avg.Weighted Avg.Weighted Avg.
AmountInterest RateAmountInterest RateAmountInterest Rate
Beginning balance$123,6524.91%$306,0383.60%$288,3863.63%
Debt transferred in—%—%12,0723.89%
Debt extinguished(46,402)5.43%(176,875)2.03%—%
Principal payments(4,679)5.14%(4,376)5.16%(4,017)5.21%
Foreign currency(35)5.43%(1,135)2.97%9,5972.99%
Ending balance$72,5364.57%$123,6524.91%$306,0383.60%
Monthly averages$117,9664.90%$215,7963.85%$294,0803.63%

A portion of our Triple-net properties were formed through partnerships. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. The increase in income from unconsolidated entities during the year ended December 31, 2021 is primarily related to the reserves established on straight-line rent receivable balances at unconsolidated Genesis entities in the prior year. Net income attributable to noncontrolling interests represents our partners’ share of net income relating to those partnerships where we are the controlling partner.

Outpatient Medical

The following is a summary of our SSNOI at Welltower Share for the Outpatient Medical segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2021December 31, 2020$%December 31, 2021December 31, 2020$%
SSNOI(1)$101,599$100,185$1,4141.4%$386,411$375,497$10,9142.9%

(1) Relates to 350 properties for the QTD Pool and 331 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

The following is a summary of our results of operations for the Outpatient Medical segment for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20212020$%2019$%$%
Revenues:
Rental income$613,254$709,584$(96,330)-14%$684,602$24,9824%$(71,348)-10%
Interest income8,7925,9132,87949%1,1954,718395%7,597636%
Other income13,2434,5228,721193%2,0312,491123%11,212552%
Total revenues635,289720,019(84,730)-12%687,82832,1915%(52,539)-8%
Property operating expenses186,939214,948(28,009)-13%218,793(3,845)-2%(31,854)-15%
NOI(1)448,350505,071(56,721)-11%469,03536,0368%(20,685)-4%
Other expenses:
Depreciation and amortization223,302261,371(38,069)-15%241,25820,1138%(17,956)-7%
Interest expense17,50617,579(73)%13,4114,16831%4,09531%
Loss (gain) on extinguishment of debt, net(4)1,046(1,050)-100%1,046n/a(4)n/a
Provision for loan losses, net(3,463)3,202(6,665)-208%3,202n/a(3,463)n/a
Impairment of assets2,2112,211n/a14,062(14,062)-100%(11,851)-84%
Other expenses2,5238,218(5,695)-69%1,7886,430360%73541%
242,075291,416(49,341)-17%270,51920,8978%(28,444)-11%
Income from continuing operations before income taxes and other item206,275213,655(7,380)-3%198,51615,1398%7,7594%
Income (loss) from unconsolidated entities(4,395)7,312(11,707)-160%7,0612514%(11,456)-162%
Gain (loss) on real estate dispositions, net93,348695,918(602,570)-87%972694,946n/a92,376n/a
Income from continuing operations295,228916,885(621,657)-68%206,549710,336344%88,67943%
Net income (loss)295,228916,885(621,657)-68%206,549710,336344%88,67943%
Less: Net income (loss) attributable to noncontrolling interests4,916(278)5,194n/a5,194(5,472)-105%(278)-5%
Net income (loss) attributable to common stockholders$290,312$917,163$(626,851)-68%$201,355$715,808355%$88,95744%

(1) See Non-GAAP Financial Measures below.

59

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Rental income has decreased due primarily to significant dispositions that closed during 2020. Certain of our leases contain annual rental escalators that are contingent upon changes in the Consumer Price Index. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. If the Consumer Price Index does not increase, a portion of our revenues may not continue to increase. Our leases could renew above or below current rental rates, resulting in an increase or decrease in rental income. For the three months ended December 31, 2021, our consolidated Outpatient Medical portfolio signed 143,266 square feet of new leases and 203,285 square feet of renewals. The weighted-average term of these leases was seven years, with a rate of $36.65 per square foot and tenant improvement and lease commission costs of $51.78 per square foot. Substantially all of these leases contain an annual fixed or contingent escalation rent structure ranging from 1.0% to 10.0%.

We have collected virtually all rent due through the year ended December 31, 2021, with uncollected amounts primarily attributable to local jurisdictions with COVID-19 related ordinances providing temporary rent relief to tenants. We evaluate leases individually and recognize rent on a cash basis if collectibility of substantially all contractual rent payments is not probable.

The increase in interest income for the year ended December 31, 2021 is due primarily to a $178,207,000 first mortgage initiated in August 2020, which was subsequently repaid in full in June of 2021, resulting in the reversal of the previously established allowance for credit losses.

The fluctuation in property operating expenses and depreciation and amortization are primarily attributable to the significant dispositions that occurred in 2020. To the extent that we acquire or dispose of additional properties in the future, these amounts will change accordingly. During the year ended December 31, 2021, we recognized an impairment charge of $2,211,000 related to one held for sale property. Transaction costs related to asset acquisitions are capitalized as a component of purchase price. The fluctuation in other expenses is primarily due to noncapitalizable transaction costs. Changes in gains/losses on sales of properties are related to volume of property sales and the sales prices.

During the year ended December 31, 2021, we completed three Outpatient Medical construction projects representing $125,179,000 or $605 per square foot. The following is a summary of our consolidated Outpatient Medical construction projects, excluding expansions, pending as of December 31, 2021 (dollars in thousands):

LocationSquare FeetCommitmentBalanceEst. Completion
Tyler, TX85,214$35,369$14,5344Q22
Stafford, TX36,78818,0314,2494Q22
Total122,002$53,400$18,783

Total interest expense represents secured debt interest expense. The change in secured debt interest expense is primarily due to the net effect and timing of assumptions, extinguishments and principal amortizations. The following is a summary of our Outpatient Medical secured debt principal activity for the periods presented (dollars in thousands):

Year EndedYear EndedYear Ended
December 31, 2021December 31, 2020December 31, 2019
Weighted Avg.Weighted Avg.Weighted Avg.
AmountInterest RateAmountInterest RateAmountInterest Rate
Beginning balance$548,2293.55%$572,2673.97%$386,7384.20%
Debt assumed—%—%202,0844.12%
Debt extinguished(7,670)5.64%(14,205)5.34%(10,244)5.75%
Principal payments(10,305)4.43%(9,833)4.60%(6,311)4.97%
Ending balance$530,2543.49%$548,2293.55%$572,2673.97%
Monthly averages$540,9473.52%$562,0173.72%$397,7564.15%

A portion of our Outpatient Medical properties were formed through partnerships. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. Net income attributable to noncontrolling interests represents our partners’ share of net income or loss relating to those partnerships where we are the controlling partner.

60

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Non-Segment/Corporate

The following is a summary of our results of operations for the Non-Segment/Corporate activities for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20212020$%2019$%$%
Revenues:
Other income$2,992$2,781$2118%$3,966$(1,185)-30%$(974)-25%
Total revenues2,9922,7812118%3,966(1,185)-30%(974)-25%
Property operating expenses8,8173,3815,436161%3,381n/a8,817n/a
NOI(1)(5,825)(600)(5,225)-871%3,966(4,566)-115%(9,791)-247%
Other expenses:
Interest expense426,644432,431(5,787)-1%461,273(28,842)-6%(34,629)-8%
General and administrative expenses126,727128,394(1,667)-1%126,5491,8451%178%
Loss (gain) on extinguishments of debt, net52,50633,34419,16257%82,541(49,197)-60%(30,035)-36%
Other expenses7,89524,929(17,034)-68%10,70514,224133%(2,810)-26%
Total expenses613,772619,098(5,326)-1%681,068(61,970)-9%(67,296)-10%
Loss from continuing operations before income taxes and other items(619,597)(619,698)101%(677,102)57,4048%57,5058%
Income tax benefit (expense)(8,713)(9,968)1,25513%(2,957)(7,011)-237%(5,756)-195%
Loss from continuing operations(628,310)(629,666)1,356%(680,059)50,3937%51,7498%
Net loss attributable to common stockholders$(628,310)$(629,666)$1,356%$(680,059)$50,3937%$51,7498%

(1) See Non-GAAP Financial Measures below.

Property operating expenses represent insurance costs related to our captive insurance company formed as of July 1, 2020, which acts as a direct insurer of property level insurance coverage for our portfolio.

The following is a summary of our Non-Segment/Corporate interest expense for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20212020$%2019$%$%
Senior unsecured notes$401,247$400,014$1,233%$402,133$(2,119)-1%$(886)%
Unsecured credit facility and commercial paper program6,75915,313(8,554)-56%43,861(28,548)-65%(37,102)-85%
Loan expense18,63817,1041,5349%15,2791,82512%3,35922%
Totals$426,644$432,431$(5,787)-1%$461,273$(28,842)-6%$(34,629)-8%

The change in interest expense on senior unsecured notes is due to the net effect of issuances and extinguishments, as well as the movement in foreign exchange rates and related hedge activity. Please refer to Note 11 to the consolidated financial statements for additional information. The change in interest expense on our unsecured revolving credit facility and commercial paper program is due primarily to the net effect and timing of draws, paydowns and variable interest rate changes. Please refer to Note 10 of our consolidated financial statements for additional information. Loan expenses represent the amortization of costs incurred in connection with senior unsecured notes issuances. The loss on extinguishment recognized during the year ended December 31, 2021 is due primarily to the early extinguishment of $339,128,000 of our 3.75% senior unsecured notes due March 2023 and $334,624,000 of our 3.95% senior unsecured notes due September 2023. The loss on extinguishment recognized during the year ended December 31, 2020 is due primarily to the early extinguishment of $160,872,000 of our 3.75% senior unsecured notes due March 2023 and $265,376,000 of our 3.95% senior unsecured notes due September 2023.

General and administrative expenses as a percentage of consolidated revenues for the years ended December 31, 2021, 2020 and 2019 were 2.67%, 2.79% and 2.47%, respectively. Other expenses for all years include severance-related costs associated with the departure of certain executive officers and key employees. The provision for income taxes primarily relates to state taxes, foreign taxes and taxes based on income generated by entities that are structured as TRSs.

Other

Non-GAAP Financial Measures

We believe that net income and net income attributable to common stockholders, as defined by U.S. GAAP, are the most appropriate earnings measurements. However, we consider FFO, NOI, SSNOI, EBITDA and Adjusted EBITDA to be useful supplemental measures of our operating performance. Historical cost accounting for real estate assets in accordance with U.S. GAAP implicitly assumes that the value of real estate assets diminishes predictably over time as evidenced by the provision for depreciation. However, since real estate values have historically risen or fallen with market conditions, many industry investors and analysts have considered presentations of operating results for real estate companies that use historical cost accounting to

61

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

be insufficient. In response, the National Association of Real Estate Investment Trusts (“NAREIT”) created funds from operations attributable to common stockholders (“FFO”) as a supplemental measure of operating performance for REITs that excludes historical cost depreciation from net income. FFO, as defined by NAREIT, means NICS, computed in accordance with U.S. GAAP, excluding gains (or losses) from sales of real estate and impairment of depreciable assets, plus depreciation and amortization, and after adjustments for unconsolidated entities and noncontrolling interests.

NOI is used to evaluate the operating performance of our properties. We define NOI as total revenues, including tenant reimbursements, less property operating expenses. Property operating expenses represent costs associated with managing, maintaining and servicing tenants for our properties. These expenses include, but are not limited to, property-related payroll and benefits, property management fees paid to operators, marketing, housekeeping, food service, maintenance, utilities, property taxes and insurance. General and administrative expenses represent costs unrelated to property operations. These expenses include, but are not limited to, payroll and benefits, professional services, office expenses and depreciation of corporate fixed assets. Same store NOI (“SSNOI”) is used to evaluate the operating performance of our properties using a consistent population which controls for changes in the composition of our portfolio. We believe the drivers of property level NOI for both consolidated properties and unconsolidated properties are generally the same and therefore, we evaluate SSNOI based on our ownership interest in each property ("Welltower Share"). To arrive at Welltower's Share, NOI is adjusted by adding our minority ownership share related to unconsolidated properties and by subtracting the minority partners' noncontrolling ownership interests for consolidated properties. We do not control investments in unconsolidated properties and while we consider disclosures at Welltower Share to be useful, they may not accurately depict the legal and economic implications of our joint venture arrangements and should be used with caution. As used herein, same store is generally defined as those revenue-generating properties in the portfolio for the relevant year-over-year reporting periods. Acquisitions and development conversions are included in SSNOI five full quarters or eight full quarters after acquisition or being placed into service for the QTD Pool and the YTD Pool, respectively. Land parcels, loans and sub-leases, as well as any properties sold or classified as held for sale during the respective periods are excluded from SSNOI. Redeveloped properties (including major refurbishments of a Seniors Housing Operating property where 20% or more of units are simultaneously taken out of commission for 30 days or more or Outpatient Medical properties undergoing a change in intended use) are excluded from SSNOI until five full quarters or eight full quarters post completion of the redevelopment for the QTD Pool and YTD Pool, respectively. Properties undergoing operator transitions and/or segment transitions are also excluded from SSNOI until five full quarters or eight full quarters post completion of the transition for the QTD Pool and YTD Pool, respectively. In addition, properties significantly impacted by force majeure, acts of God, or other extraordinary adverse events are excluded from SSNOI until five full quarters or eight full quarters after the properties are placed back into service for the QTD Pool and YTD Pool, respectively. SSNOI excludes non-cash NOI and includes adjustments to present consistent ownership percentages and to translate Canadian properties and U.K. properties using a consistent exchange rate. We believe NOI and SSNOI provide investors relevant and useful information because they measure the operating performance of our properties at the property level on an unleveraged basis. We use NOI and SSNOI to make decisions about resource allocations and to assess the property level performance of our properties.

EBITDA is defined as earnings (net income) before interest, taxes, depreciation and amortization. Adjusted EBITDA is defined as EBITDA excluding unconsolidated entities and including adjustments for stock-based compensation expense, provision for loan losses, gains/losses on extinguishment of debt, gains/loss/impairments on properties, gains/losses on derivatives and financial instruments, other expenses, other impairment charges and other adjustments as deemed appropriate. We believe that EBITDA and Adjusted EBITDA, along with net income, are important supplemental measures because they provide additional information to assess and evaluate the performance of our operations. We primarily use these measures to determine our interest coverage ratio, which represents EBITDA and Adjusted EBITDA divided by total interest, and our fixed charge coverage ratio, which represents EBITDA and Adjusted EBITDA divided by fixed charges. Fixed charges include total interest and secured debt principal amortization. Covenants in our unsecured senior notes and primary credit facility contain financial ratios based on a definition of EBITDA and Adjusted EBITDA that is specific to those agreements. Our leverage ratios are defined as the proportion of net debt to total capitalization and include book capitalization, undepreciated book capitalization and market capitalization. Book capitalization represents the sum of net debt (defined as total long-term debt, excluding operating lease liabilities, less cash and cash equivalents and restricted cash), total equity and redeemable noncontrolling interests. Undepreciated book capitalization represents book capitalization adjusted for accumulated depreciation and amortization. Market capitalization represents book capitalization adjusted for the fair market value of our common stock.

Our supplemental reporting measures and similarly entitled financial measures are widely used by investors, equity and debt analysts and rating agencies in the valuation, comparison, rating and investment recommendations of companies. Management uses these financial measures to facilitate internal and external comparisons to our historical operating results and in making operating decisions. Additionally, these measures are utilized by the Board of Directors to evaluate management. None of our supplemental measures represent net income or cash flow provided from operating activities as determined in accordance with U.S. GAAP and should not be considered as alternative measures of profitability or liquidity. Finally, the supplemental measures, as defined by us, may not be comparable to similarly entitled items reported by other real estate investment trusts or other companies.

62

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The table below reflects the reconciliation of FFO to NICS, the most directly comparable U.S. GAAP measure, for the periods presented. Noncontrolling interest and unconsolidated entity amounts represent adjustments to reflect our share of depreciation and amortization, gains/loss on real estate dispositions and impairment of assets. Amounts are in thousands except for per share data.

Year Ended December 31,
FFO Reconciliation:202120202019
Net income attributable to common stockholders$336,138$978,844$1,232,432
Depreciation and amortization1,037,5661,038,4371,027,073
Impairment of assets51,107135,60828,133
Loss (gain) on real estate dispositions, net(235,375)(1,088,455)(748,041)
Noncontrolling interests(54,190)(23,968)(20,197)
Unconsolidated entities85,47662,09657,680
Funds from operations attributable to common stockholders$1,220,722$1,102,562$1,577,080
Average diluted shares outstanding:426,841417,387403,808
Per diluted share data:
Net income attributable to common stockholders(1)$0.78$2.33$3.05
Funds from operations attributable to common stockholders$2.86$2.64$3.91
(1) Includes adjustment to the numerator for income (loss) attributable to OP unitholders.

The following tables reflect the reconciliation of consolidated NOI to net income, the most directly comparable U.S. GAAP measure, for the years presented. Dollar amounts are in thousands.

Year Ended December 31,
NOI Reconciliation:202120202019
Net income (loss)$374,479$1,038,852$1,330,410
Loss (gain) on real estate dispositions, net(235,375)(1,088,455)(748,041)
Loss (income) from unconsolidated entities22,9338,083(42,434)
Income tax expense (benefit)8,7139,9682,957
Other expenses41,73970,33552,612
Impairment of assets51,107135,60828,133
Provision for loan losses, net7,27094,43618,690
Loss (gain) on extinguishment of debt, net49,87447,04984,155
Loss (gain) on derivatives and financial instruments, net(7,333)11,049(4,399)
General and administrative expenses126,727128,394126,549
Depreciation and amortization1,037,5661,038,4371,027,073
Interest expense489,853514,388555,559
Consolidated net operating income (NOI)$1,967,553$2,008,144$2,431,264
NOI by segment:
Seniors Housing Operating$683,906$755,552$1,039,520
Triple-net841,122748,121918,743
Outpatient Medical448,350505,071469,035
Non-segment/corporate(5,825)(600)3,966
Total NOI$1,967,553$2,008,144$2,431,264

63

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Quarterly NOI by Segment:
(in thousands)Three Months EndedYear Ended
March 31,June 30,September 30,December 31,December 31,
2021202020212020202120202021202020212020
Seniors Housing Operating:
Total revenues$726,402$851,128$742,549$773,650$839,519$742,065$904,780$715,020$3,213,250$3,081,863
Property operating expenses555,968607,871582,361595,513666,610567,704724,405555,2232,529,3442,326,311
Consolidated NOI$170,434$243,257$160,188$178,137$172,909$174,361$180,375$159,797$683,906$755,552
Triple-net:
Total revenues$168,482$207,729$238,941$233,619$239,985$120,928$243,176$239,028$890,584$801,304
Property operating expenses12,84113,30212,62713,56311,66412,56712,33013,75149,46253,183
Consolidated NOI$155,641$194,427$226,314$220,056$228,321$108,361$230,846$225,277$841,122$748,121
Outpatient Medical:
Total revenues$156,223$199,329$159,072$180,831$159,503$172,704$160,491$167,155$635,289$720,019
Property operating expenses46,86360,60845,49551,68848,07252,72846,50949,924186,939214,948
Consolidated NOI$109,360$138,721$113,577$129,143$111,431$119,976$113,982$117,231$448,350$505,071
Corporate:
Total revenues$955$416$430$375$790$1,177$817$813$2,992$2,781
Property operating expenses1,6542,1743,0541,7181,9351,6638,8173,381
Consolidated NOI$(699)$416$(1,744)$375$(2,264)$(541)$(1,118)$(850)$(5,825)$(600)

The following is a reconciliation of the properties included in our QTD Pool and YTD Pool for SSNOI:

QTD PoolYTD Pool
SSNOI Property Reconciliations:Seniors Housing OperatingTriple-netOutpatient MedicalTotalSeniors Housing OperatingTriple-netOutpatient MedicalTotal
Consolidated properties7216243061,6517216243061,651
Unconsolidated properties923979210923979210
Total properties8136633851,8618136633851,861
Recent acquisitions/development conversions(1)(183)(48)(23)(254)(193)(50)(42)(285)
Under development(35)(5)(3)(43)(35)(5)(3)(43)
Under redevelopment(2)(2)(1)(2)(5)(3)(1)(2)(6)
Current held for sale(2)(14)(1)(17)(2)(14)(1)(17)
Land parcels, loans and subleases(18)(19)(6)(43)(18)(19)(6)(43)
Transitions(3)(82)(20)(102)(83)(25)(108)
Other(4)(2)(2)(4)(2)(2)(4)
Same store properties4895543501,3934775473311,355
(1) Acquisitions and development conversions will enter the QTD Pool and YTD Pool five full quarters and eight full quarters after acquisition or certificate of occupancy, respectively.
(2) Redevelopment properties will enter the QTD Pool and YTD Pool after five full quarters and eight full quarters of operations post redevelopment completion, respectively.
(3) Transitioned properties will enter the QTD Pool and YTD Pool after five full quarters and eight full quarters of operations with the new operator in place or under the new structure, respectively.
(4) Represents properties that are either closed or being closed.

64

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a reconciliation of our consolidated NOI to same store NOI for the periods presented for the respective pools. Dollar amounts are in thousands.

QTD PoolYTD Pool
Three Months EndedTwelve Months Ended
SSNOI Reconciliations:December 31, 2021December 31, 2020December 31, 2021December 31, 2020
Seniors Housing Operating:
Consolidated NOI$180,375$159,797$683,906$755,552
NOI attributable to unconsolidated investments10,71313,18244,47053,736
NOI attributable to noncontrolling interests(12,125)(9,405)(59,602)(49,070)
Non-cash NOI attributable to same store properties(35)(381)11,266(3,390)
NOI attributable to non-same store properties(42,733)(20,058)(135,437)(109,345)
Currency and ownership adjustments (1)1491,062(848)5,340
SSNOI at Welltower Share136,344144,197543,755652,823
Triple-net:
Consolidated NOI230,846225,277841,122748,121
NOI attributable to unconsolidated investments4,8934,81819,55913,796
NOI attributable to noncontrolling interests(13,600)(14,563)(48,874)(58,245)
Non-cash NOI attributable to same store properties(6,854)(10,176)15,778(16,453)
NOI attributable to non-same store properties(67,192)(62,498)(258,800)(122,851)
Currency and ownership adjustments (1)4141,2736996,428
SSNOI at Welltower Share148,507144,131569,484570,796
Outpatient Medical:
Consolidated NOI113,982117,231448,350505,071
NOI attributable to unconsolidated investments4,6823,60918,99810,139
NOI attributable to noncontrolling interests(4,896)(4,392)(17,168)(15,070)
Non-cash NOI attributable to same store properties(2,483)(3,092)(8,140)(12,392)
NOI attributable to non-same store properties(9,446)(7,476)(54,490)(68,633)
Currency and ownership adjustments (1)(240)(5,695)(1,139)(43,618)
SSNOI at Welltower Share101,599100,185386,411375,497
SSNOI at Welltower Share:
Seniors Housing Operating136,344144,197543,755652,823
Triple-net148,507144,131569,484570,796
Outpatient Medical101,599100,185386,411375,497
Total$386,450$388,513$1,499,650$1,599,116
(1) Includes adjustments to reflect consistent property ownership percentages, to translate Canadian properties at a USD/CAD rate of 1.2684 and to translate U.K. properties at a GBP/USD rate of 1.38.

65

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The table below reflects the reconciliation of EBITDA and Adjusted EBITDA to net income, the most directly comparable U.S. GAAP measure, for the periods presented. Dollars are in thousands.

Year Ended December 31,
Adjusted EBITDA Reconciliation:202120202019
Net income (loss)$374,479$1,038,852$1,330,410
Interest expense489,853514,388555,559
Income tax expense (benefit)8,7139,9682,957
Depreciation and amortization1,037,5661,038,4371,027,073
EBITDA1,910,6112,601,6452,915,999
Loss (income) from unconsolidated entities22,9338,083(42,434)
Stock-based compensation expense(1)17,81228,31825,047
Loss (gain) on extinguishment of debt, net49,87447,04984,155
Loss (gain) on real estate dispositions, net(235,375)(1,088,455)(748,041)
Impairment of assets51,107135,60828,133
Provision for loan losses, net7,27094,43618,690
Loss (gain) on derivatives and financial instruments, net(7,333)11,049(4,399)
Other expenses(1)40,86064,17151,052
Leasehold interest adjustment (2)760
Casualty losses, net of recoveries (3)5,786
Other impairment (4)49,241146,508
Adjusted EBITDA$1,913,546$2,048,412$2,328,202
Adjusted Interest Coverage Ratio:
Interest expense$489,853$514,388$555,559
Capitalized interest19,35217,47215,272
Non-cash interest expense(17,506)(15,751)(8,645)
Total interest491,699516,109562,186
Adjusted EBITDA$1,913,546$2,048,412$2,328,202
Adjusted interest coverage ratio3.89x3.97x4.14x
Adjusted Fixed Charge Coverage Ratio:
Total interest$491,699$516,109$562,186
Secured debt principal payments65,58762,70754,325
Total fixed charges557,286578,816616,511
Adjusted EBITDA$1,913,546$2,048,412$2,328,202
Adjusted fixed charge coverage ratio3.43x3.54x3.78x

(1) Certain severance-related costs are included in stock-based compensation and excluded from other expenses.

(2) Represents $27,988,000 of revenue and $28,748,000 of property operating expenses associated with a leasehold portfolio interest relating to 26 properties assumed by a wholly-owned affiliate in conjunction with the Holiday Retirement transaction. Subsequent to the initial transaction, we purchased eight of the leased properties and one of the properties was sold by the landlord and removed from the lease. No rent will be paid in excess of net cash flow relating to the leasehold properties and therefore, the net impact has been excluded from Adjusted EBITDA.

(3) Represents casualty losses, net of any insurance recoveries.

(4) Represents reserve for straight-line rent receivables balances relating to leases placed on cash recognition.

Our leverage ratios include book capitalization, undepreciated book capitalization and market capitalization. Book capitalization represents the sum of net debt (defined as total long-term debt less cash and cash equivalents and restricted cash), total equity and redeemable noncontrolling interests. Undepreciated book capitalization represents book capitalization adjusted for accumulated depreciation and amortization. Market capitalization represents book capitalization adjusted for the fair market value of our common stock. Our leverage ratios are defined as the proportion of net debt to total capitalization. The table below reflects the reconciliation of our leverage ratios to our balance sheets for the periods presented. Amounts are in thousands, except share price.

66

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Year Ended December 31,
202120202019
Book capitalization:
Unsecured credit facility and commercial paper$324,935$$1,587,597
Long-term debt obligations(1)13,917,70213,905,82213,436,365
Cash and cash equivalents and restricted cash(346,755)(2,021,043)(385,766)
Total net debt13,895,88211,884,77914,638,196
Total equity and noncontrolling interests(2)18,997,87317,225,06216,982,504
Book capitalization$32,893,755$29,109,841$31,620,700
Net debt to book capitalization ratio42.2%40.8%46.3%
Undepreciated book capitalization:
Total net debt$13,895,882$11,884,779$14,638,196
Accumulated depreciation and amortization6,910,1146,104,2975,715,459
Total equity and noncontrolling interests(2)18,997,87317,225,06216,982,504
Undepreciated book capitalization$39,803,869$35,214,138$37,336,159
Net debt to undepreciated book capitalization ratio34.9%33.8%39.2%
Market capitalization:
Common shares outstanding447,239417,401410,257
Period end share price$85.77$64.62$81.78
Common equity market capitalization$38,359,689$26,972,453$33,550,817
Total net debt13,895,88211,884,77914,638,196
Noncontrolling interests(2)1,361,8721,252,3431,442,060
Market capitalization:$53,617,443$40,109,575$49,631,073
Net debt to market capitalization ratio25.9%29.6%29.5%

(1) Amounts include senior unsecured notes, secured debt and lease liabilities related to finance leases, as reflected on our Consolidated Balance Sheets. Operating lease liabilities related to the ASC 842 adoption are excluded.

(2) Includes amounts attributable to both redeemable noncontrolling interests and noncontrolling interests as reflected on our Consolidated Balance Sheets.

Critical Accounting Policies & Estimates

Our consolidated financial statements are prepared in accordance with U.S. GAAP, which requires us to make estimates and assumptions. Management considers an accounting estimate or assumption critical if:

•the nature of the estimates or assumptions is material due to the levels of subjectivity and judgment necessary to account for highly uncertain matters or the susceptibility of such matters to change; and

•the impact of the estimates and assumptions on financial condition or operating performance is material.

Management has discussed the development and selection of its critical accounting policies and estimates with the Audit Committee of the Board of Directors. Management believes the current assumptions and other considerations used to estimate amounts reflected in our consolidated financial statements are appropriate and are not reasonably likely to change in the future. However, since these estimates require assumptions to be made that were uncertain at the time the estimate was made, they bear the risk of change. If actual experience differs from the assumptions and other considerations used in estimating amounts reflected in our consolidated financial statements, the resulting changes could have a material adverse effect on our consolidated results of operations, liquidity and/or financial condition. Please refer to Note 2 to our consolidated financial statements for further information on significant accounting policies that impact us and for the impact of new accounting standards, including accounting pronouncements that were issued but not yet adopted by us.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following table presents information about our critical accounting policies and estimates:

Nature of Critical Accounting EstimateAssumptions/Approach Used
Impairment of Real Property Assessing impairment of real property involves subjectivity in determining if indicators of impairment are present and in estimating the future undiscounted cash flows or estimated fair value of an asset. In estimating the undiscounted cash flows or fair value, key assumptions that would be made are the estimation of future rental revenues, operating expenses, capitalization rates and the ability and intent to hold the respective asset, all of which are affected by our expectations of future market or economic conditions. These estimates can have a significant impact on the undiscounted cash flows or estimated fair value of an asset.Quarterly, we evaluate our real estate investments on a property by property basis to determine if there are indicators of impairment. These indicators may include expected operational performance, the tenant's ability to make rent payments, a decision to dispose of an asset before the end of its estimated useful life and changes in the market that may permanently reduce the value of the property. If indicators of impairment exist, an undiscounted cash flow analysis will be prepared and the results of such analysis will be compared to the current net book value to determine if an impairment charge is necessary. This analysis requires us to use judgment in determining whether indicators of impairment exist and to estimate the expected future undiscounted cash flows or estimated fair values of the property. Properties that meet the held for sale criteria are recorded at the lesser of the fair value less costs to sell or carrying value. At December 31, 2021, our net real property owned was approximately $30,695,633,000. During the year ended December 31, 2021, we recorded impairment charges of $19,567,000 related to four Triple-net properties and one Outpatient Medical property which were disposed of or classified as held for sale for which the carrying values exceeded the fair values. Additionally, we recorded $31,540,000 of impairment charges related to two Seniors Housing Operating properties and two Triple-net properties that were held for use in which the carrying values exceeded the estimated fair values.
Real Estate Acquisitions We believe that substantially all of our real estate acquisitions are considered asset acquisitions for which we record the related real estate acquired (tangible assets and identifiable intangible assets and liabilities) at cost on a relative fair value basis. Liabilities assumed and any associated noncontrolling interests are reflected at fair value. Tangible assets consist primarily of land, building and improvements. Identifiable intangible assets and liabilities primarily consist of the above or below market component of in-place leases and the value of in-place leases. The total amount of other intangible assets acquired is further allocated to in-place lease values and customer relationship values based on management's evaluation of the specific characteristics of each tenant's lease and our overall relationship with respect to that tenant.The allocation of the purchase price to the related real estate acquired (tangible assets and intangible assets and liabilities) involves subjectivity as such allocations are based on a relative fair value analysis. In determining the fair values that drive such analysis, we estimate the fair value of each component of the real estate acquired which generally includes land, buildings and improvements, the above or below market component of in-place leases and the value of in-place leases. Significant assumptions used to determine such fair values include comparable land sales, capitalization rates, discount rates, market rental rates and property operating data, all of which can be impacted by expectations about future market or economic conditions. Our estimates of the values of these components affect the amount of depreciation and amortization we record over the estimated useful life of the property or the term of the lease. During the year ended December 31, 2021, we completed $4,084,174,000 of real estate acquisitions. These transactions were accounted for as asset acquisitions and the purchase price of each was allocated based on the relative fair values of the assets acquired and liabilities assumed.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Nature of Critical Accounting EstimateAssumptions/Approach Used
Principles of Consolidation The consolidated financial statements include our accounts, the accounts of our wholly-owned subsidiaries, and the accounts of joint venture entities in which we own a majority voting interest with the ability to control operations and where no substantive participating rights or substantive kick out rights have been granted to the noncontrolling interests. In addition, we consolidate those entities deemed to be variable interest entities (“VIEs”) in which we are determined to be the primary beneficiary. All material intercompany transactions and balances have been eliminated in consolidation.We make judgments about which entities are VIEs based on an assessment of whether (i) the equity investors as a group, if any, do not have a controlling financial interest, or (ii) the equity investment at risk is insufficient to finance that entity’s activities without additional subordinated financial support. We make judgments with respect to our level of influence or control of an entity and whether we are (or are not) the primary beneficiary of a VIE. Consideration of various factors includes, but is not limited to, our ability to direct the activities that most significantly impact the entity's economic performance, our form of ownership interest, our representation on the entity's governing body, the size and seniority of our investment, our ability and the rights of other investors to participate in policy making decisions, replace the manager and/or liquidate the entity, if applicable. Our ability to correctly assess our influence or control over an entity at inception of our involvement or on a continuous basis when determining the primary beneficiary of a VIE affects the presentation of these entities in our consolidated financial statements. If we perform a primary beneficiary analysis at a date other than at inception of the VIE, our assumptions may be different and may result in the identification of a different primary beneficiary.
Allowance for Credit Losses on Loans Receivable The allowance for credit losses is maintained at a level believed adequate to absorb potential losses in our loans receivable. The determination of the credit allowance is based on a quarterly evaluation of all outstanding loans, including general economic conditions and estimated collectability of loan payments.The determination of the allowance for credit losses is based on a quarterly evaluation of all outstanding loans, including general economic conditions and estimated collectability of loan payments. We evaluate the collectability of our loans receivable based on a combination of factors, including, but not limited to, payment status, historical loan charge-offs, financial strength of the borrower and guarantors, and nature, extent and value of the underlying collateral. A loan is considered to have deteriorated credit quality when, based on current information and events, it is probable that we will be unable to collect all amounts due as scheduled according to the contractual terms of the loan agreement. For those loans we identified as having deteriorated credit quality, we determine the amount of credit loss on an individual basis. Placement on non-accrual status may be required. Consistent with this definition, all loans on non-accrual are deemed to have deteriorated credit quality. To the extent circumstances improve and the risk of collectability is diminished, we may return these loans to income accrual status. While a loan is on non-accrual status, any cash receipts are applied against the outstanding principal balance. For the remaining loans, we assess credit loss on a collective pool basis and use our historical loss experience for similar loans to determine the reserve for credit losses. During the year ended December 31, 2021, we recognized provision for loan losses of $7,270,000 based on our historical loss experience.

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